Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | MA00018689 | WA |
NPI | 1780801829 |
---|---|
Provider Name | Lennie Warhank |
First Address | Marysville, WA 98270-2235 |
Second Address | Marysville, WA 98270-2235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0177216 | DEPT. OF LABOR & INDUSTRI (01) | WA |