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General NPI Number Information
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NPI Number | 1588238877
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Entity Type | Individual
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Provider Name | JOSHUA LEE EMMIL
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Gender | Male
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 507 HOSPITAL WAY
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City | BREWSTER
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State | WA
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Zip | 98812-0019
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Country | US
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Telephone | 509-689-2517
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Fax |
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Provider Business Mailing Address
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Address Line | 5 LINDELL RD
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City | OMAK
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State | WA
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Zip | 98841-6101
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Country | US
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Telephone | 360-957-1415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI61099363
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License Number State | WA
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