Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MD00016301 | WA |
Y | 207SG0201X | Clinical Genetics (M.D.) | MD00016301 | WA |
NPI | 1033294855 |
---|---|
Provider Name | Virginia P Sybert |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98195-6127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 25/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033294855 | (05) | WA |
84760 | INTERNAL ID-MOTOR VEHICLE ID (01) | |
A05747 | (02) |