Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 9688 | WA |
NPI | 1538194071 |
---|---|
Provider Name | William J Elton |
First Address | Longview, WA 98632 |
Second Address | Longview, WA 98632-2315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 04/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8112906 | (05) | WA |
D33890 | (02) |