Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | OP00001440 | WA |
Y | 207YP0228X | Pediatric Otolaryngology | OP00001440 | WA |
NPI | 1104907468 |
---|---|
Provider Name | Jonathan A Perkins |
First Address | Seattle, WA 98105-3900 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 12/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3397 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
8160632 | (05) | WA |