Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD00026913 | WA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD00026913 | WA |
NPI | 1255419610 |
---|---|
Provider Name | Gretchen M Lentz |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-6158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0231458 | L&I (01) | WA |
1255419610 | (05) | WA |
7099 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
F08882 | (02) |