Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 00000626 | WA |
N | 175F00000X | Naturopath | 000035 | PR |
NPI | 1033557616 |
---|---|
Provider Name | Dr. Jeana Denise Kimball |
First Address | Seattle, WA 98101-1771 |
Second Address | Seattle, WA 98101-1771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 29/09/2015 |