Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1696 | OR |
NPI | 1093040412 |
---|---|
Provider Name | Dr. Elena A. Panutich |
First Address | Vancouver, WA 98686-3273 |
Second Address | Vancouver, WA 98686-3273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2009 |
Last Update Date | 01/04/2014 |