Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD00033066 | WA |
NPI | 1013989979 |
---|---|
Provider Name | Kenneth N Mahrer |
First Address | Seattle, WA 98101-1873 |
Second Address | Seattle, WA 98101-2756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 17/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060051021 | RAILROAD MEDICARE (01) | WA |
806332000 | IDAHO MEDICAID (01) | WA |
8180978 | (05) | WA |
G13774 | (02) | |
MA5090 | INDIVIDUAL BLUE SHIELD (01) | WA |
MD6633 | ALASKA MEDICAID (01) | WA |