Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DE60220469 | WA |
N | 1223G0001X | General Practice | DD2756 | NM |
N | 213EG0000X | General Practice | DD2756 | NM |
NPI | 1003848938 |
---|---|
Provider Name | Karen Lovato |
First Address | Mill Creek, WA 98012-9002 |
Second Address | Mill Creek, WA 98012-9002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 02/12/2015 |