Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN-11 | WA |
NPI | 1619063476 |
---|---|
Provider Name | Ms. Herminia Hilo Subaran |
First Address | Seattle, WA 98133-6202 |
Second Address | Seattle, WA 98133-6202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5020599 | (05) | WA |