Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 48539 | TN |
N | 207X00000X | Orthopaedic Surgeon | MD60296681 | WA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD60296681 | WA |
NPI | 1205033784 |
---|---|
Provider Name | Mr. Grant R. Lohse |
First Address | Seattle, WA 98104-1172 |
Second Address | Bellevue, WA 98004-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 01/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
313804 | LABOR & INDUSTRIES (01) | WA |
G8921986 | MEDICARE PTAN (01) | WA |
P01301076 | MEDICARE RR (01) | WA |