Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD00028075 | WA |
NPI | 1013057769 |
---|---|
Provider Name | Robert E Piston |
First Address | Seattle, WA 98124-1584 |
Second Address | Spokane, WA 99208-1124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 26/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0042210 | (05) | ID |
G42077 | (02) | WA |