Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD00019596 | WA |
NPI | 1003802679 |
---|---|
Provider Name | Karen L. Bohmke |
First Address | Seattle, WA 98104-1306 |
Second Address | Seattle, WA 98104-1306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 23/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000054 | (05) | WA |