Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00001436 | WA |
N | 176B00000X | Midwife | MW00000303 | WA |
NPI | 1093965154 |
---|---|
Provider Name | Dr. Chenelle A Roberts |
First Address | Seattle, WA 98107-3940 |
Second Address | Seattle, WA 98107-3940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2008 |
Last Update Date | 25/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7131816 | (05) | WA |