Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD00034852 | WA |
NPI | 1073557120 |
---|---|
Provider Name | Laura Jeannine Hart |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F90460 | (02) | AK |