Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT61007396 | WA |
NPI | 1104467778 |
---|---|
Provider Name | Dr. Lara A Thompson |
First Address | Bothell, WA 98011-1584 |
Second Address | Everett, WA 98201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2019 |
Last Update Date | 22/10/2019 |