Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 6595 | WA |
NPI | 1194865162 |
---|---|
Provider Name | Dr. Timothy J. Butson |
First Address | Auburn, WA 98092-3235 |
Second Address | Seattle, WA 98101-1878 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |