Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD00044989 | WA |
N | 111NI0900X | Internist | MD00044989 | WA |
Y | 207RI0200X | Infectious Disease | MD00044989 | WA |
NPI | 1033166624 |
---|---|
Provider Name | Dr. Taylor Gordon Sandison |
First Address | Oakland, CA 94611-1206 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 19/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0247881 | LABOR & INDUSTRIES (01) | WA |
8427510 | (05) | WA |
I04280 | (02) | WA |