Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DE00007902 | WA |
NPI | 1093865826 |
---|---|
Provider Name | Dr. Timothy Sweatman |
First Address | Spokane, WA 99218-1257 |
Second Address | Spokane, WA 99218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 08/07/2007 |