Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 4430 | OR |
NPI | 1063176089 |
---|---|
Provider Name | Dr. Michelle Marie Ritola |
First Address | Kelso, WA 98626-1304 |
Second Address | Kelso, WA 98626-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2021 |
Last Update Date | 26/10/2021 |