Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | MD00048021 | WA |
N | 208000000X | Pediatrician | MD00048021 | WA |
NPI | 1245204635 |
---|---|
Provider Name | John Lawrence Merritt II |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 18/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
689443700 | (05) | MN |
8481269 | (05) | WA |
H29727 | (02) |