Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT 60024453 | WA |
NPI | 1104067933 |
---|---|
Provider Name | Dr. Lavica Jane Barnes |
First Address | Edmonds, WA 98026-7980 |
Second Address | Edmonds, WA 98026-7980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2009 |
Last Update Date | 01/07/2010 |