Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | RN60262699 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP60942015 | WA |
NPI | 1457816035 |
---|---|
Provider Name | James R Case |
First Address | Pasco, WA 99301-8216 |
Second Address | Yakima, WA 98902-1133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2019 |
Last Update Date | 22/03/2019 |