MEDICARE: JUDITH KAYE CAPORICCIO ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	NT60057466	WA

General Provider Information

NPI Number	:	1619112760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH KAYE CAPORICCIO ND

Provider Business Mailing Address
First Line	:	1601 COLUMBIA PARK TRL
Second Line	:	103
City	:	RICHLAND
State	:	WA
Zip	:	99352-4772
Country	:	US
Telephone Number	:	509-736-6311
Fax Number	:	509-736-6336

Provider Business Practice Location Address
First Line	:	1601 COLUMBIA PARK TRL
Second Line	:	103
City	:	RICHLAND
State	:	WA
Zip	:	99352-4772
Country	:	US
Telephone Number	:	509-736-6311
Fax Number	:	509-736-6336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	08/15/2011

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