Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD195622 | OR |
N | 207U00000X | Nuclear Medicine Specialist | MD60993530 | WA |
NPI | 1396999512 |
---|---|
Provider Name | Dr. Shree Krishna Subedi |
First Address | Tacoma, WA 98401-1535 |
Second Address | Tacoma, WA 98402-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0414629 | L&I-TRA PIERCE (01) | WA |
0414630 | L&I-TRA KING (01) | WA |
0414631 | L&I-UAOM (01) | WA |
0414632 | L&I-DINW (01) | WA |
2141551 | (05) | WA |