Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DENR.DN.60658397 | WA |
NPI | 1346792207 |
---|---|
Provider Name | Naser Al Tameemi |
First Address | Morton, WA 98356 |
Second Address | Morton, WA 98356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2016 |
Last Update Date | 26/10/2016 |