Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT 60268654 | WA |
NPI | 1033477476 |
---|---|
Provider Name | Dr. Jodi Renee Vingelen |
First Address | Kenmore, WA 98028-4605 |
Second Address | Kenmore, WA 98028-4605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2012 |
Last Update Date | 23/04/2012 |