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General NPI Number Information
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NPI Number | 1497290415
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Entity Type | Organization
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Legal Business Name | TEYOLIA NATURAL MEDICINE
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 408 E MAIN ST
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8506
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Country | US
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Telephone | 360-687-4492
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Fax |
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Provider Business Mailing Address
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Address Line | 408 E MAIN ST
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8506
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Country | US
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Telephone | 360-687-4492
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Fax |
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Authorized Official
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Title or Position | NATUROPATHIC PHYSICIAN
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Name | DR. VENESSA MADRIGAL
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Credential | ND
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Telephone | 805-234-1156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | NT60707283
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License Number State | WA
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