Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA 60199402 | WA |
NPI | 1255639944 |
---|---|
Provider Name | Mrs. Kirsten Sunshine Berry |
First Address | Spokane, WA 99202-4320 |
Second Address | Spokane Valley, WA 99206-4932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2011 |
Last Update Date | 04/03/2011 |