Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD00037736 | WA |
NPI | 1033299953 |
---|---|
Provider Name | Michael J Doherty |
First Address | Seattle, WA 98124-8426 |
Second Address | Seattle, WA 98122-5788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 11/05/2021 |