Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO00000459 | WA |
NPI | 1407945348 |
---|---|
Provider Name | Lyle K Lorimer |
First Address | Bellevue, WA 98007-4115 |
Second Address | Bellevue, WA 98007-4115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1086180 | (05) | WA |
U20852 | (02) |