Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD00046966 | WA |
Y | 2080P0216X | Pediatric Rheumatologist | MD00046966 | WA |
NPI | 1982714341 |
---|---|
Provider Name | Jennifer C Wargula |
First Address | Seattle, WA 98105-1010 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 03/02/2009 |