Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | M2598 | TX |
NPI | 1891764353 |
---|---|
Provider Name | Maria Teresa De La Morena |
First Address | Seattle, WA 98105 |
Second Address | Seattle, WA 98105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 09/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060847302 | (05) | TX |
H01288 | (02) |