Healthcare Provider Details

I. General information

NPI: 1215590104
Provider Name (Legal Business Name): NATALIE STARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 SW CITY VIEW ST
PULLMAN WA
99163-2110
US

IV. Provider business mailing address

925 SW CITY VIEW ST
PULLMAN WA
99163-2110
US

V. Phone/Fax

Practice location:
  • Phone: 509-592-5578
  • Fax:
Mailing address:
  • Phone: 509-592-5578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: