Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 60847067 | WA |
NPI | 1003310533 |
---|---|
Provider Name | Se He Han |
First Address | Seattle, WA 98195-0001 |
Second Address | Seattle, WA 98195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 01/07/2018 |