Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD00047785 | WA |
N | 111NI0900X | Internist | MD00047785 | WA |
N | 207RC0200X | Critical Care Medicine | MD00047785 | WA |
Y | 207RP1001X | Pulmonary Disease | MD00047785 | WA |
N | 207RS0012X | Sleep Medicine | MD00047785 | WA |
NPI | 1023197258 |
---|---|
Provider Name | Pawan Chawla |
First Address | Tacoma, WA 98405-5309 |
Second Address | Tacoma, WA 98405-5307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 02/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1090618 | (05) | WA |
8518060 | (05) | WA |
I44340 | (02) | WA |