Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | TR60384598 | WA |
N | 208200000X | Surgeon | TR60384598 | WA |
N | 208600000X | Surgeon | TR60384598 | WA |
NPI | 1134403215 |
---|---|
Provider Name | Imran Javed |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2011 |
Last Update Date | 29/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1134403215 | (05) | WA |