Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 295776 | NY |
Y | 207U00000X | Nuclear Medicine Specialist | MD60851665 | WA |
NPI | 1154432094 |
---|---|
Provider Name | Dr. Thomas Andrew Webster |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-1089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05374034 | (05) | NY |