Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD00014420 | WA |
NPI | 1013949486 |
---|---|
Provider Name | Terrence J Ball |
First Address | Seattle, WA 98101-1873 |
Second Address | Federal Way, WA 98003-6208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 06/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039580 | LABOR & INDUSTRY (01) | WA |
6081BA | BLUE SHIELD (01) | WA |
8260507 | (05) | WA |
A14693 | (02) | |
US0899617 | AETNA/USHC SPECIALIST (01) | WA |