=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427324052
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TILIA NATURAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2012
-----------------------------------------------------
Last Update Date | 03/28/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 NE 56TH ST
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98105-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-257-5817
-----------------------------------------------------
Fax | 206-257-5819
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 NE 56TH ST
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98105-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-257-5817
-----------------------------------------------------
Fax | 206-257-5819
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. LAURA WALTON
-----------------------------------------------------
Credential | N.D.
-----------------------------------------------------
Telephone | 206-257-5817
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | NT00001440
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------