Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1104113695 |
---|---|
Provider Name | Dr. Greg Lamontmitchell |
First Address | Bellevue, WA 98004-3011 |
Second Address | Bellevue, WA 98004-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 24/01/2014 |