Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | HL00007798 | WA |
NPI | 1083018139 |
---|---|
Provider Name | Jo Umano |
First Address | Seattle, WA 98124-1703 |
Second Address | Seattle, WA 98108-4813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2014 |
Last Update Date | 17/10/2014 |