Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD00021745 | WA |
NPI | 1033157102 |
---|---|
Provider Name | Scott Slaymaker |
First Address | Burien, WA 98166-2962 |
Second Address | Burien, WA 98166-2962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 23/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A05645 | (02) | WA |