Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN 60051783 | WA |
NPI | 1710214812 |
---|---|
Provider Name | Thomas E Hauser |
First Address | Auburn, WA 98002-5748 |
Second Address | Auburn, WA 98002-5748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2009 |
Last Update Date | 10/11/2009 |