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General NPI Number Information
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NPI Number | 1538573274
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Entity Type | Organization
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Legal Business Name | DAHLIA NATURAL HEALTH CLINIC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 11301 5TH AVE NE STE F
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City | SEATTLE
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State | WA
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Zip | 98125-6152
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Country | US
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Telephone | 425-954-6771
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Fax | 206-453-4165
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Provider Business Mailing Address
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Address Line | 11301 5TH AVE NE STE F
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City | SEATTLE
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State | WA
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Zip | 98125-6152
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Country | US
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Telephone | 704-651-4126
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Fax |
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Authorized Official
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Title or Position | NATUROPATHIC DOCTOR
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Name | DR. DIANE MOAN
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Credential | ND
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Telephone | 704-651-4126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT60421434
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License Number State | WA
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