Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO460 | WA |
N | 222Z00000X | Podiatrist | PO460 | WA |
Y | 213ES0131X | Foot Surgery | PO00000460 | WA |
NPI | 1063428779 |
---|---|
Provider Name | Mr. Rodney George Yen |
First Address | Seattle, WA 98104-1172 |
Second Address | Seattle, WA 98104-2120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 29/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1076918 | (05) | WA |
U23785 | (02) | WA |