Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 603395904 | WA |
NPI | 1669886255 |
---|---|
Provider Name | Ms. Katrina Anne Navarro |
First Address | Mountlake Terrace, WA 98043-4939 |
Second Address | Mountlake Terrace, WA 98043-4939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2014 |
Last Update Date | 11/06/2014 |