Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MD 00032252 | WA |
NPI | 1093085615 |
---|---|
Provider Name | Jo A Deevey |
First Address | Snoqualmie, WA 98065-1485 |
Second Address | Snoqualmie, WA 98065-9657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2012 |
Last Update Date | 12/01/2012 |