Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | MD60575995 | WA |
Y | 213ES0000X | Sports Medicine | MD60575995 | WA |
NPI | 1114238615 |
---|---|
Provider Name | Dr. Stephen Gingrich |
First Address | Seattle, WA 98144-2712 |
Second Address | Seattle, WA 98144-2712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 18/05/2021 |