Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | D13069 | MN |
Y | 1223P0221X | Pediatric Dentist | DE60884749 | WA |
NPI | 1083055867 |
---|---|
Provider Name | James Purcell |
First Address | Yakima, WA 98902-2437 |
Second Address | Yakima, WA 98902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2013 |
Last Update Date | 22/03/2021 |