# MAGNOLIA NATUROPATHIC MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Magnolia Naturopathic Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043695547
- **Authorized official:** DR. LAURA ELAYNE FIRETAG ND (NATUROPATHIC PHYSICIAN)
- **Authorized official phone:** (843) 209-3966

## Contact information

- **Practice address:** 803 39TH AVE SW STE F, PUYALLUP, WA 98373-3692
- **Practice address phone:** (253) 848-1055
- **Practice address fax:** (253) 848-5533
- **Mailing address:** 803 39TH AVE SW STE F, PUYALLUP, WA 98373-3692
- **Mailing address phone:** (253) 848-1055
- **Mailing address fax:** (253) 848-5533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | NT60524427 | WA | Yes |

## Other

- **Enumeration date:** 07/25/2015
- **Last updated:** 07/25/2015