Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | MA0015385 | WA |
NPI | 1396942728 |
---|---|
Provider Name | Ms. Bettina Dara Ramick |
First Address | Pacific, WA 98047-1450 |
Second Address | Kent, WA 98030-7610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA00015385 | LICENSE (01) | WA |