Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00001595 | WA |
NPI | 1053596981 |
---|---|
Provider Name | Dr. Vivian Luciana Sovran |
First Address | Kirkland, WA 98034-3027 |
Second Address | Kirkland, WA 98034-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2008 |
Last Update Date | 09/01/2008 |