Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD00037403 | WA |
N | 208600000X | Surgeon | MD00037403 | WA |
Y | 2086S0102X | Surgical Critical Care | MD00037403 | WA |
NPI | 1275619066 |
---|---|
Provider Name | Lisa Kuwamura Mcintyre |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 19/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1275619066 | (05) | WA |
3681 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
H51025 | (02) |