Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD00029565 | WA |
NPI | 1558422683 |
---|---|
Provider Name | Jan Sunde |
First Address | Tacoma, WA 98405-4210 |
Second Address | Tacoma, WA 98405-4210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 04/12/2020 |