Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1376810283 |
---|---|
Provider Name | Catherine Mary Fenner |
First Address | Shoreline, WA 98177-2544 |
Second Address | Shoreline, WA 98177-2544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2011 |
Last Update Date | 20/11/2011 |