Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD00042475 | WA |
NPI | 1073580536 |
---|---|
Provider Name | Walter Holder JR. |
First Address | Seattle, WA 98122-4201 |
Second Address | Seattle, WA 98122-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8355893 | (05) | WA |
A37272 | (02) | WA |