Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | NT00001187 | WA |
NPI | 1023151081 |
---|---|
Provider Name | Mr. Michael Corsilles |
First Address | Bellevue, WA 98004-3016 |
Second Address | Seattle, WA 98126-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 06/09/2018 |