Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN 60543725 | WA |
NPI | 1306211289 |
---|---|
Provider Name | Mr. Joshua Barrett |
First Address | Gig Harbor, WA 98335-2057 |
Second Address | Gig Harbor, WA 98335-2057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2015 |
Last Update Date | 03/12/2015 |