Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA 60040455 | WA |
NPI | 1023275005 |
---|---|
Provider Name | Sherry D Gleave |
First Address | Vancouver, WA 98663-3369 |
Second Address | Vancouver, WA 98663-3369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 06/01/2011 |