Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD00046133 | WA |
NPI | 1013973254 |
---|---|
Provider Name | Robert Samuel Wirthlin |
First Address | Spokane, WA 99204-2509 |
Second Address | Spokane, WA 99204-2509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 07/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0207068 | LABOR AND INDUSTRIES (01) | WA |
1730187899 | SPOKANE EYE CLINIC, PS (01) | WA |
1831165331 | SPOKANE EYE SURGERY CENTER (01) | WA |
910852217 | PREMERA BLUE CROSS (01) | WA |
I06872 | (02) | WA |