Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 98-01573 | NC |
Y | 207L00000X | Anesthesiologist | TR60264609 | WA |
NPI | 1013091164 |
---|---|
Provider Name | Prof. Georg Burkhard Mackensen |
First Address | Seattle, WA 98195-0001 |
Second Address | Seattle, WA 98195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 24/01/2015 |