Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD00020264 | WA |
NPI | 1003855495 |
---|---|
Provider Name | Phillip Mcguiness |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Wenatchee, WA 98801-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003855495 | (05) | WA |
P01791147 | RR MEDICARE WVH (01) | WA |