Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 63274 | AZ |
N | 207R00000X | Internist | 267817 | MA |
N | 111NI0900X | Internist | 267817 | MA |
NPI | 1033568761 |
---|---|
Provider Name | Jacqueline Watchmaker |
First Address | Scottsdale, AZ 85254-5216 |
Second Address | Scottsdale, AZ 85254-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2016 |
Last Update Date | 31/08/2021 |