Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | MD60258488 | WA |
Y | 2086S0105X | Surgery of the Hand | MD60258488 | WA |
NPI | 1164433561 |
---|---|
Provider Name | Jeffrey Allan Pratt |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Wenatchee, WA 98801-6697 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 14/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164433561 | (05) | WA |
322563 | WVH LNI (01) | WA |