Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 04-29790 | KS |
N | 207PP0204X | Pediatric Emergency Physician | 15442 | NV |
N | 207PP0204X | Pediatric Emergency Physician | MD60427484 | WA |
Y | 2080P0204X | Pediatric Emergency Doctor | MD60427484 | WA |
NPI | 1154529238 |
---|---|
Provider Name | Ramona C Warren |
First Address | Tacoma, WA 98405-4234 |
Second Address | Tacoma, WA 98405-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 08/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H67072 | (02) | KS |