Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD60844929 | WA |
N | 207VG0400X | Gynecologist | 60844929 | WA |
NPI | 1033523675 |
---|---|
Provider Name | Tariro Mupombwa |
First Address | Seattle, WA 98104 |
Second Address | Seattle, WA 98104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2014 |
Last Update Date | 04/09/2018 |