Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | MD00014913 | WA |
NPI | 1326105578 |
---|---|
Provider Name | Jerome L. Billingsley |
First Address | Tacoma, WA 98431-1100 |
Second Address | Tacoma, WA 98431-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |