Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT00000532 | WA |
NPI | 1003962309 |
---|---|
Provider Name | Rick Marschall |
First Address | Port Angeles, WA 98362-9202 |
Second Address | Port Angeles, WA 98362-9202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA9555 | (02) | WA |