Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | MD27383 | OR |
Y | 2081P2900X | Pain Medicine | MD60055113 | WA |
NPI | 1215058607 |
---|---|
Provider Name | Matthew James Mcgehee |
First Address | Vancouver, WA 98664-3299 |
Second Address | Vancouver, WA 98664-3299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 23/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G8952501 | (02) | WA |