Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD60508339 | WA |
NPI | 1003022112 |
---|---|
Provider Name | Leticia Ayala Maragh |
First Address | Seattle, WA 98124-1876 |
Second Address | Newcastle, WA 98056-1412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 01/10/2014 |