Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD00044750 | WA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD00044750 | WA |
NPI | 1174575518 |
---|---|
Provider Name | Janice L Levesque Bishop |
First Address | Bellevue, WA 98006 |
Second Address | Bellevue, WA 98006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8435414 | (05) | WA |
F00630 | (02) | |
F00630 | (02) | WA |