Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | MD61089899 | WA |
Y | 2086S0120X | Pediatric Surgery | MD60661651 | WA |
NPI | 1356632939 |
---|---|
Provider Name | Matthew Blair Dellinger |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2011 |
Last Update Date | 26/08/2021 |