Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1402 | WA |
NPI | 1104023480 |
---|---|
Provider Name | Dr. Thomas Andrew Griffith |
First Address | Olympia, WA 98501 |
Second Address | Olympia, WA 98502-5014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 31/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1402 | STATE ND LICENSE (01) | WA |