Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO00000296 | WA |
NPI | 1023184868 |
---|---|
Provider Name | Dr. William Berg Warnekros |
First Address | Seattle, WA 98105-4028 |
Second Address | Seattle, WA 98105-4093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17212 | LABOR & INDUSTRY # (01) | WA |
1726405 | (05) | WA |
T83858 | (02) | WA |