Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT 60251745 | WA |
NPI | 1073890612 |
---|---|
Provider Name | Dr. Elisha Faye Bokman |
First Address | Shoreline, WA 98133-3104 |
Second Address | Shoreline, WA 98133-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2011 |
Last Update Date | 10/11/2011 |