Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO00000508 | WA |
NPI | 1619041456 |
---|---|
Provider Name | Karen Skidmore |
First Address | Poulsbo, WA 98370-9099 |
Second Address | Poulsbo, WA 98370-9099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 22/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010913 | PACIFICARE (01) | WA |
0166066 | LABOR & INDUSTRIES (01) | WA |
141708141710 | PREMERA (01) | WA |
2106608 | COMMUNITY HLTH NETWORK WA (01) | WA |
4550430 | AETNA (01) | WA |
8477598 | (05) | WA |
91217091100 | UNIFORM MEDICAL PLAN (01) | WA |
9121709110001 | CIGNA HEALTH CARE (01) | WA |
91217091101 | KPS (01) | WA |
DA5130 | RAILROAD MEDICARE (01) | WA |
U43825 | (02) | WA |
WA9999 | MUTUAL OF OMAHA (01) | WA |