Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT61107505 | WA |
NPI | 1144859679 |
---|---|
Provider Name | David Fell |
First Address | Yelm, WA 98597-9009 |
Second Address | Yelm, WA 98597-7646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2020 |
Last Update Date | 20/10/2020 |