Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00001064 | WA |
NPI | 1083779441 |
---|---|
Provider Name | Dr. John Joseph Nowicki |
First Address | Issaquah, WA 98027-8927 |
Second Address | Issaquah, WA 98027-8927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 08/07/2007 |