Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD00035499 | WA |
N | 208600000X | Surgeon | MD00035499 | WA |
N | 2086S0102X | Surgical Critical Care | MD00035499 | WA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD00035499 | WA |
NPI | 1023077500 |
---|---|
Provider Name | Mr. Riyad Caradog Karmy-Jones |
First Address | Vancouver, WA 98668-8945 |
Second Address | Portland, OR 97227-1683 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 13/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8218794 | (05) | WA |
G21321 | (02) |