Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD60217248 | WA |
Y | 2080P0208X | Pediatric Infectious Diseases | MD60217248 | WA |
NPI | 1518121805 |
---|---|
Provider Name | Rafael Epitacio Hernandez |
First Address | Seattle, WA 98145-5005 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 18/03/2015 |