Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 252-05-677 | WA |
N | 176B00000X | Midwife | 252-13-160 | WA |
NPI | 1104918234 |
---|---|
Provider Name | Dr. Virginia Laing Frazer |
First Address | Kennewick, WA 99336-3928 |
Second Address | Kennewick, WA 99336-3928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 24/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252-05-677 | ND LICENSE NUMBER (01) | WA |
252-13-160 | LM LICENSE NUMBER (01) | WA |