Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT60869102 | WA |
NPI | 1124592431 |
---|---|
Provider Name | Dr. Andrea E Gruszecki |
First Address | Renton, WA 98057-5803 |
Second Address | Renton, WA 98057-5803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2019 |
Last Update Date | 20/01/2019 |