Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | WA |
NPI | 1124634753 |
---|---|
Provider Name | Dr. Maria Luisa Gussak |
First Address | Cle Elum, WA 98922-9603 |
Second Address | Cle Elum, WA 98922-9603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2020 |
Last Update Date | 18/09/2020 |