Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE00004998 | WA |
NPI | 1093832800 |
---|---|
Provider Name | Robert C. S. Woo |
First Address | Auburn, WA 98002-4700 |
Second Address | Auburn, WA 98002-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T01911 | (02) | WA |