Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1083703664 |
---|---|
Provider Name | Dr. Paul Edward Reilly |
First Address | Fife, WA 98424-1148 |
Second Address | Fife, WA 98424-1148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 02/12/2016 |