Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN00000031 | WA |
NPI | 1275859712 |
---|---|
Provider Name | Romulo Luarca Inocencio |
First Address | Seattle, WA 98118-3179 |
Second Address | Seattle, WA 98118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 08/04/2010 |