Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD00035217 | WA |
Y | 207QA0505X | Family Doctor - Adult Medicine | MD00035217 | WA |
NPI | 1205858123 |
---|---|
Provider Name | Gia L Hemmen |
First Address | Renton, WA 98057-4970 |
Second Address | Kent, WA 98030-6443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043248 | (05) | WA |
8235343 | (05) | WA |
G83613 | (02) | WA |
G8891565 | MEDICARE (01) | WA |