Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA00011973 | WA |
NPI | 1487772711 |
---|---|
Provider Name | Ronda Coones |
First Address | Vancouver, WA 98684-6015 |
Second Address | Vancouver, WA 98684-4091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 21/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1487772711 | MASSAGE THERAPY (01) | WA |