Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0089146 | FL |
N | 111NI0900X | Internist | ME0089146 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | MD00046468 | WA |
NPI | 1336191618 |
---|---|
Provider Name | Juan Iregui |
First Address | University Place, WA 98466-4614 |
Second Address | University Place, WA 98466-4614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0210626 | STATE L&I (01) | WA |
0240615 | STATE L&I (01) | WA |
271170200 | (05) | FL |
8457285 | (05) | WA |
8941690 | STATE CRIME VICTIMS (01) | WA |
8948910 | STATE CRIME VICTIMS (01) | WA |
H76621 | (02) |