Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00001033 | WA |
NPI | 1003948373 |
---|---|
Provider Name | Dr. Kevin D Connor |
First Address | Seattle, WA 98124-6209 |
Second Address | Seattle, WA 98103-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 23/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2036851 | (05) | WA |