Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 125071731 | IL |
N | 207Q00000X | Family Doctor | MD.MD.61167828 | WA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD.MD.61167828 | WA |
NPI | 1033603840 |
---|---|
Provider Name | Taisha Doo |
First Address | Glenview, IL 60026-1324 |
Second Address | Seattle, WA 98104-1316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2018 |
Last Update Date | 22/12/2021 |