Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD00036505 | WA |
NPI | 1003955360 |
---|---|
Provider Name | Harlan Ray White |
First Address | Seattle, WA 98122-2735 |
Second Address | Seattle, WA 98122-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 23/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G89734 | (02) | WA |