=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427296284
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANEL NEWMAN-KOVACEV ND
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2009
-----------------------------------------------------
Last Update Date | 06/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27121 174TH PL SE SUITE 203
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98042-4939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-277-1308
-----------------------------------------------------
Fax | 253-277-0720
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27121 174TH PL SE STE 203
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98042-4939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-277-1308
-----------------------------------------------------
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 | NT60061032
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------