Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD00037197 | WA |
NPI | 1205855038 |
---|---|
Provider Name | Mary H Czuk |
First Address | Seattle, WA 98101-1873 |
Second Address | Federal Way, WA 98003-6208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 07/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039592 | LABOR & INDUSTRY (01) | WA |
8244493 | (05) | WA |
CZ3312 | BLUE SHIELD (01) | WA |
H06281 | (02) | |
MD3719 | ALASKA MEDICAID (01) | WA |
US7330017 | AETNA/USHC SPECIALIST (01) | WA |