Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD61051383 | WA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD61051383 | WA |
NPI | 1235285842 |
---|---|
Provider Name | Dr. Sara Elizabeth Mazzoni |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 01/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1235285842 | (05) | WA |