Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD00037791 | WA |
NPI | 1003991811 |
---|---|
Provider Name | Michael S Mulligan |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-5791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 11/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0231621 | L&I (01) | WA |
1000239 | (05) | WA |
1003991811 | (05) | WA |
252490 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
G13641 | (02) |