Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00001545 | WA |
NPI | 1093981334 |
---|---|
Provider Name | Dr. Julia Susanne Stevens |
First Address | Coeur D Alene, ID 83814-6104 |
Second Address | Coeur D Alene, ID 83814-6104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 06/05/2008 |