Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1720403876 |
---|---|
Provider Name | Julio Quesada |
First Address | Seattle, WA 98168-2044 |
Second Address | Seattle, WA 98168-2044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2014 |
Last Update Date | 03/03/2014 |