Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH00006389 | WA |
NPI | 1053468686 |
---|---|
Provider Name | Mr. Robert Alan Howard |
First Address | West Richland, WA 99353-4007 |
Second Address | Richland, WA 99352-9628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5901798 | (05) | WA |