Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 11195819-1205 | UT |
Y | 207Q00000X | Family Doctor | MD61062541 | WA |
N | 207QS0010X | Family Doctor - Sports Medicine | 11195819-1205 | UT |
N | 207QS0010X | Family Doctor - Sports Medicine | MD61062541 | WA |
NPI | 1073961439 |
---|---|
Provider Name | William H West |
First Address | Richland, WA 99352-9532 |
Second Address | Richland, WA 99352-4714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 21/07/2020 |