Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD00030841 | WA |
NPI | 1083674683 |
---|---|
Provider Name | James C Watson |
First Address | Seattle, WA 98122-4201 |
Second Address | Seattle, WA 98122-5698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 25/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1100189 | (05) | WA |
F53970 | (02) | WA |