Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT60454183 | WA |
NPI | 1073938585 |
---|---|
Provider Name | Lily Jei-Ho Chang |
First Address | Kirkland, WA 98034-2847 |
Second Address | Kirkland, WA 98125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2014 |
Last Update Date | 03/05/2017 |