Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | OS00000012 | WA |
NPI | 1700995461 |
---|---|
Provider Name | Gregory Thomas Sankey |
First Address | Seattle, WA 98125-7452 |
Second Address | Seattle, WA 98125-7452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
344581001 | GROUP HEALTH COOP (01) | WA |
37189 | LABOR & INDUSTRY PROVIDER (01) | WA |
8917595 | CRIME VICTIMS (01) | WA |
9033929 | (05) | WA |
911508025 | FEDERAL TAX ID# (01) | WA |
CU0117 | REGENCE PROVIDER # (01) | WA |
PO4547 | (05) | AK |
PO45471 | ALASKA MEDICAID # (01) | AK |