Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MD 60143548 | WA |
NPI | 1306904552 |
---|---|
Provider Name | Nathan Lee Frost |
First Address | Olympia, WA 98502-5429 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 20/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD 60143548 | WASHINGTON STATE LICENSE NUMBER (01) | WA |