Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT61057037 | WA |
NPI | 1104454230 |
---|---|
Provider Name | Benjamin M Magoun |
First Address | Snoqualmie, WA 98065-5109 |
Second Address | Snoqualmie, WA 98065-5109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2020 |
Last Update Date | 01/04/2020 |