Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT 60322999 | WA |
NPI | 1013357219 |
---|---|
Provider Name | Dr. Nancy J Ellis |
First Address | Kenmore, WA 98028-4966 |
Second Address | Kenmore, WA 98028-4966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2013 |
Last Update Date | 02/07/2013 |