Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD00046152 | WA |
NPI | 1659300374 |
---|---|
Provider Name | Jeffrey Todd Allgaier |
First Address | Kennewick, WA 99336-8108 |
Second Address | Fargo, ND 58104-7539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0209137 | LIWA (01) | WA |
0216265 | LIWA (01) | WA |
0218208 | LIWA (01) | WA |
0227596 | LIWA (01) | WA |
2031254 | (05) | WA |
3075AL | BSWA (01) | WA |
3079AL | BSWA (01) | WA |
3752AL | BSWA (01) | WA |
605960012 | USDLAB (01) | WA |
6593AL | BSWA (01) | WA |
8452922 | (05) | WA |
8946277 | VICTIMS OF CRIME (01) | WA |
ALL1970 | (02) | WA |