Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH00034868 | WA |
NPI | 1033389952 |
---|---|
Provider Name | Dr. Dawn Michelle Smallwood |
First Address | Ronald, WA 98940-0154 |
Second Address | Cle Elum, WA 98922-1124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 18/11/2017 |