Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD00015443 | WA |
NPI | 1003917295 |
---|---|
Provider Name | Robert F Wachtel |
First Address | Tacoma, WA 98415-0299 |
Second Address | Tacoma, WA 98405-4234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |