Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD00026518 | WA |
NPI | 1003807702 |
---|---|
Provider Name | Joann Alexanian |
First Address | Tacoma, WA 98411-6626 |
Second Address | Lakewood, WA 98499-3004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1055557 | (05) | WA |
E09577 | (02) |