Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH00002865 | WA |
NPI | 1013270396 |
---|---|
Provider Name | Miss Susan Lyn Mcdowell |
First Address | Cheney, WA 99004-9625 |
Second Address | Spokane, WA 99205-1482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 21/06/2012 |