Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 60953462 | WA |
NPI | 1013304328 |
---|---|
Provider Name | Parker Faith |
First Address | Yakima, WA 98902-6341 |
Second Address | Yakima, WA 98902-6341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 02/08/2019 |