Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 4660 | WA |
NPI | 1164494191 |
---|---|
Provider Name | Robert J Oswald |
First Address | Kirkland, WA 98034-7201 |
Second Address | Kirkland, WA 98034-7201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/07/2007 |