Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA00024503 | WA |
NPI | 1609148154 |
---|---|
Provider Name | Kari Lyn Tippett |
First Address | Puyallup, WA 98375-8708 |
Second Address | Puyallup, WA 98373-7820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2012 |
Last Update Date | 30/01/2012 |