Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD00049125 | WA |
NPI | 1003928839 |
---|---|
Provider Name | Jonathan P Kryman |
First Address | Tacoma, WA 98405-4265 |
Second Address | Tacoma, WA 98405-4265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 26/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G8880586 | (05) | WA |
G8880763 | (05) | WA |