Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD60080408 | WA |
N | 208000000X | Pediatrician | 1336-TEP | WI |
N | 2080P0201X | Pediatric Allergist | MD60080408 | WA |
NPI | 1548226285 |
---|---|
Provider Name | Kevin T Dooms |
First Address | Bellevue, WA 98004-3732 |
Second Address | Bellevue, WA 98004-3732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 22/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0067890 | L&I (01) | WA |
8547648 | (05) | WA |
G8882793 | (02) | WA |