Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OP 000802 | WA |
NPI | 1447463401 |
---|---|
Provider Name | Margaret Ann Sorrel |
First Address | Freeland, WA 98249-1312 |
Second Address | Freeland, WA 98249-1312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D33698 | (02) | WA |