Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH00001142 | WA |
NPI | 1003976796 |
---|---|
Provider Name | Ms. Teresa Elizabeth Gauld |
First Address | Seattle, WA 98117-2547 |
Second Address | Seattle, WA 98122-4304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DH00001142 | WA ST. DENTAL HYGIENE LIC (01) | WA |