Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | OI6027313 | WA |
N | 222Z00000X | Podiatrist | OI6027313 | WA |
Y | 224P00000X | Prosthetist | PS60197750 | WA |
NPI | 1265715593 |
---|---|
Provider Name | Jay C Sciortino |
First Address | Vancouver, WA 98664-1988 |
Second Address | Vancouver, WA 98664-1988 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2011 |
Last Update Date | 22/09/2011 |