Healthcare Provider Details

I. General information

NPI: 1245694827
Provider Name (Legal Business Name): PRIYA WALIA MS AYU, N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 112TH AVE NE
BELLEVUE WA
98004-2946
US

IV. Provider business mailing address

1806 S HOSMER ST
TACOMA WA
98405-3219
US

V. Phone/Fax

Practice location:
  • Phone: 425-453-8022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60612357
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: