Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MD00011262 | WA |
NPI | 1265534028 |
---|---|
Provider Name | Dr. Thomas Dwight Bird |
First Address | Seattle, WA 98195-0001 |
Second Address | Seattle, WA 98108-1532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 14/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AO4085 | (02) | WA |