Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD60048334 | WA |
NPI | 1073753661 |
---|---|
Provider Name | Mr. Matthew Nathan Ashbach |
First Address | Everett, WA 98201-4290 |
Second Address | Everett, WA 98201-4290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 23/02/2009 |