Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR.CH.60836756 | WA |
N | 175F00000X | Naturopath | NT60736006 | WA |
NPI | 1154630069 |
---|---|
Provider Name | Dr. Derek Simpson |
First Address | Yelm, WA 98597-8328 |
Second Address | Yelm, WA 98597-8328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2010 |
Last Update Date | 19/06/2019 |