Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD00026495 | WA |
NPI | 1013939438 |
---|---|
Provider Name | John James Rooks |
First Address | Lakewood, WA 98499-8135 |
Second Address | Lakewood, WA 98499-8120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 30/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1120062 | (05) | WA |
D57996 | (02) | WA |