Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA60789072 | WA |
NPI | 1245757517 |
---|---|
Provider Name | Dayna Hart |
First Address | Kent, WA 98031-2068 |
Second Address | Kent, WA 98030-4965 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2017 |
Last Update Date | 27/08/2017 |