Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD00043805 | WA |
NPI | 1013911619 |
---|---|
Provider Name | Dr. Spencer A Coray |
First Address | Seattle, WA 98104-1172 |
Second Address | Lakewood, WA 98499-8000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 18/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H77398 | (02) | WA |