Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA00023416 | WA |
NPI | 1487836573 |
---|---|
Provider Name | Tammy Jo White |
First Address | Richland, WA 99352-6661 |
Second Address | West Richland, WA 99353-7353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2007 |
Last Update Date | 29/11/2007 |