Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD00033791 | WA |
NPI | 1144309402 |
---|---|
Provider Name | Robin D Ifft |
First Address | Seattle, WA 98101-2756 |
Second Address | Seattle, WA 98101-2756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039577 | L&I (01) | WA |
8232126 | (05) | WA |
F48746 | (02) | |
IF2192 | REGENCE# (01) | WA |
US0899582 | AETNA PCP PIN (01) | WA |