=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427176403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JILLIAN ELIZABETH STANSBURY ND
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 408 E MAIN
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-687-4492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 408 E MAIN
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-687-4492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | 578
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------