Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1104442318 |
---|---|
Provider Name | Dr. Eva Freese Wilson |
First Address | Fall City, WA 98024-7103 |
Second Address | Bellevue, WA 98007-3827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2020 |
Last Update Date | 23/06/2020 |