Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA60253901 | WA |
NPI | 1669801957 |
---|---|
Provider Name | Quinessa Muhammad |
First Address | Spanaway, WA 98387-8303 |
Second Address | Tacoma, WA 98406-7204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2013 |
Last Update Date | 06/11/2013 |