Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MD00040094 | WA |
NPI | 1326191016 |
---|---|
Provider Name | Pamela Girres |
First Address | Bellevue, WA 98004-8578 |
Second Address | Bellevue, WA 98004-8578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 07/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8283988 | (05) | WA |
H54395 | (02) | WA |