Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA00024077 | WA |
NPI | 1376731240 |
---|---|
Provider Name | Ms. Summer Dawn Chavez |
First Address | Tacoma, WA 98408-5839 |
Second Address | Tacoma, WA 98408-5839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA00024077 | THERAPUTIC MASSAGE (01) | WA |