Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD00045155 | WA |
N | 207XS0117X | Orthopaedic Spine Surgeon | MD00045155 | WA |
NPI | 1346284486 |
---|---|
Provider Name | Jeffrey Seung Roh |
First Address | Seattle, WA 98122-5789 |
Second Address | Seattle, WA 98122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346284486 | (05) | WA |
I35349 | (02) |