Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 38780 | WA |
NPI | 1003895012 |
---|---|
Provider Name | Roanne R E Selinger |
First Address | Bellevue, WA 98004-4631 |
Second Address | Bellevue, WA 98004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 21/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198815 | LABOR & INDUSTRIES (01) | WA |
H39938 | (02) |