Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD00037393 | WA |
NPI | 1891876140 |
---|---|
Provider Name | Jordan M Symons |
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 | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
249080 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
8248049 | (05) | WA |
H04092 | (02) |