Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OP00000894 | WA |
NPI | 1285645523 |
---|---|
Provider Name | Dr. William Robert Loomis |
First Address | Spokane, WA 99208-1108 |
Second Address | Spokane, WA 99208-1108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A07289 | (02) |