Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD60208572 | WA |
NPI | 1003980319 |
---|---|
Provider Name | Lisa S. Callegari |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 21/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0280545 | L&I (01) | WA |
1003980319 | (05) | WA |
I46235 | (02) |