Organization
NATURAL LIFE INTEGRATIVE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA ELAYNE FIRETAG ND (MEDICAL DIRECTOR, TREASURER)
(843) 209-3966
Entity
Organization
Contact information
Practice address
102 23RD AVE SE, PUYALLUP, WA 98372-4501
(253) 268-2170
(253) 268-0658
Mailing address
102 23RD AVE SE, PUYALLUP, WA 98372-4501
(253) 268-2170
(253) 268-0658
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT60524427
WA
261QM1300X
Multi-Specialty Clinic/Center
NT60524427
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047746
—
WA
Enumeration date
09/15/2017
Last updated
07/21/2022
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