Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML 60292260 | WA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD60565171 | WA |
NPI | 1164797346 |
---|---|
Provider Name | Michael Thomas Cronin |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 13/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164797346 | (05) | WA |