Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | MD.MD.61109997 | WA |
Y | 207L00000X | Anesthesiologist | MD202307 | OR |
NPI | 1013309277 |
---|---|
Provider Name | Joshua Champion |
First Address | Vancouver, WA 98664-1988 |
Second Address | Vancouver, WA 98664-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2015 |
Last Update Date | 03/05/2021 |