MEDICARE: MS. URSULA HALL 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	NT00000521	WA

General Provider Information

NPI Number	:	1750402707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. URSULA HALL ND

Provider Business Mailing Address
First Line	:	8965 GRAVELLY LAKE DR SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3109
Country	:	US
Telephone Number	:	253-581-0408
Fax Number	:	253-589-8467

Provider Business Practice Location Address
First Line	:	8965 GRAVELLY LAKE DR SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3109
Country	:	US
Telephone Number	:	253-581-0408
Fax Number	:	253-589-8467

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

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/08/2007

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