Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD00023957 | WA |
NPI | 1073520029 |
---|---|
Provider Name | Elaine Thomas |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 25/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073520029 | (05) | WA |