Organization
MAGNOLIA NATUROPATHIC MEDICINE, LLC
Active
Other names
Magnolia Naturopathic Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA ELAYNE FIRETAG ND (NATUROPATHIC PHYSICIAN)
(843) 209-3966
Entity
Organization
Contact information
Practice address
803 39TH AVE SW STE F, PUYALLUP, WA 98373-3692
(253) 848-1055
(253) 848-5533
Mailing address
803 39TH AVE SW STE F, PUYALLUP, WA 98373-3692
(253) 848-1055
(253) 848-5533
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
NT60524427
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235537234
PROVIDER NPI
WA
Enumeration date
07/25/2015
Last updated
07/25/2015
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