Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 60341050 | WA |
NPI | 1003250853 |
---|---|
Provider Name | Dr. Samuel Philip Madeira |
First Address | Seattle, WA 98107-3911 |
Second Address | Seattle, WA 98121-1423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 09/09/2016 |