Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD23768 | OR |
NPI | 1013921659 |
---|---|
Provider Name | Dr. Xianghua Pan |
First Address | Seattle, WA 98124-5147 |
Second Address | Portland, OR 97205-3536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 18/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050089530 | RR MEDICARE (01) | OR |
1013921659 | (05) | ID |
113276 | (02) | OR |
286478 | (05) | OR |
8312225 | (05) | WA |
H62153 | (02) | |
MD3881R | (05) | AK |
XPY204589 | (05) | CA |