Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD436651 | PA |
N | 111NI0900X | Internist | MD436651 | PA |
N | 207RH0000X | Hematologist | 603839​25 | WA |
Y | 207RX0202X | Medical Oncology | 603839​25 | WA |
NPI | 1053576710 |
---|---|
Provider Name | Dr. Sasha Oommen Joseph |
First Address | Tacoma, WA 98405-5016 |
Second Address | Federal Way, WA 98003-6700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2008 |
Last Update Date | 04/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2030233 | (05) | WA |
G8921254 | (02) | WA |
P01363078 | RAILROAD MEDICARE (01) | WA |