Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD00018657 | WA |
NPI | 1013927516 |
---|---|
Provider Name | Stephen Anthony Gates |
First Address | Poulsbo, WA 98370-0107 |
Second Address | Richland, WA 99352-3514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A08416 | (02) |