Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD 60464668 | WA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD60464668 | WA |
NPI | 1083913875 |
---|---|
Provider Name | Julie M Rivers |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2011 |
Last Update Date | 21/05/2018 |