Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OI60704848 | WA |
N | 222Z00000X | Podiatrist | OI60704848 | WA |
Y | 224P00000X | Prosthetist | PS60704842 | WA |
NPI | 1275077851 |
---|---|
Provider Name | Geoffrey Balkman |
First Address | Issaquah, WA 98029-7630 |
Second Address | Seattle, WA 98109-5546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2016 |
Last Update Date | 15/12/2016 |