Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | NT60905869 | WA |
NPI | 1043736036 |
---|---|
Provider Name | Imani Owens-Bailey |
First Address | Tacoma, WA 98409-5548 |
Second Address | Tacoma, WA 98402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 24/09/2019 |