Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML60368564 | WA |
Y | 2080P0208X | Pediatric Infectious Diseases | MD60657190 | WA |
NPI | 1639448947 |
---|---|
Provider Name | Jonathan Fink Mosser |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2011 |
Last Update Date | 17/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1639448947 | (05) | WA |