Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 0000258 | WA |
NPI | 1053412098 |
---|---|
Provider Name | Ms. Satomi Hirai |
First Address | Bothell, WA 98011-3422 |
Second Address | Bothell, WA 98011-3422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5036835 | (05) | WA |
8029423 | (05) | WA |