Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD00023298 | WA |
N | 208200000X | Surgeon | C51568 | CA |
N | 208600000X | Surgeon | C51568 | CA |
N | 208200000X | Surgeon | MD00023298 | WA |
N | 208600000X | Surgeon | MD00023298 | WA |
N | 2086S0120X | Pediatric Surgery | C51568 | CA |
Y | 2086S0120X | Pediatric Surgery | MD00023298 | WA |
NPI | 1447262324 |
---|---|
Provider Name | Elizabeth Carol Pohlson |
First Address | Tacoma, WA 98405-3720 |
Second Address | Tacoma, WA 98405-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 19/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C98892 | (02) | CA |