Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | NT60903793 | WA |
Y | 225700000X | Massage Therapist | MA60511096 | WA |
NPI | 1083185680 |
---|---|
Provider Name | Dr. Rachel Anne Fry |
First Address | Woodinville, WA 98077-8056 |
Second Address | Kirkland, WA 98034-5213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2018 |
Last Update Date | 02/12/2020 |