Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT60332030 | WA |
NPI | 1144465394 |
---|---|
Provider Name | Michele Lynn Deisering |
First Address | Tumwater, WA 98501-4062 |
Second Address | Tumwater, WA 98501-4062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 23/07/2013 |