Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 17172 | WA |
NPI | 1073603148 |
---|---|
Provider Name | Dr. Thomas Wu |
First Address | Olympia, WA 98502-8147 |
Second Address | Olympia, WA 98502-8147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |