Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT0000796 | WA |
NPI | 1053544429 |
---|---|
Provider Name | Dr. Gary Lee Kiefer |
First Address | Auburn, WA 98002-3453 |
Second Address | Lakewood, WA 98499-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2009 |
Last Update Date | 01/09/2009 |