Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2204 | WA |
N | 111NN1001X | Nutrition | 2204 | WA |
NPI | 1366462848 |
---|---|
Provider Name | Dr. Karen Ann Sesso |
First Address | Spokane, WA 99205-4702 |
Second Address | Spokane, WA 99205-4702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 05/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350017492 | RAILROAD MEDICARE PTAN (01) | WA |
91-1403067 | TAX PAYOR IDENTIFICATION (01) | WA |
DSHS | 2006955 (01) | WA |
T02467 | (02) |