Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00000861 | WA |
NPI | 1083753701 |
---|---|
Provider Name | Beth Didomenico |
First Address | Federal Way, WA 98003-6311 |
Second Address | Federal Way, WA 98003-6311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 08/07/2007 |