Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 24806 | TX |
N | 213EG0000X | General Practice | 24806 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE6048933 | WA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DR60213519 | WA |
NPI | 1043440068 |
---|---|
Provider Name | Michael Houston Wasson |
First Address | Seattle, WA 98102-3307 |
Second Address | Seattle, WA 98102-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2009 |
Last Update Date | 22/07/2014 |