Organization
GAIA MED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVA KOZURA ND, RD, EAMP (DIRECTOR)
(206) 508-1300
Entity
Organization
Contact information
Practice address
5122 25TH AVE NE, SEATTLE, WA 98105
(206) 900-9798
Mailing address
5122 25TH AVE NE, SEATTLE, WA 98105-4121
(206) 900-9798
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
918610
IL
171100000X
Acupuncturist
60245607
WA
175F00000X
Naturopath
Primary
60245488
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2MP000004632060
—
WA
Enumeration date
05/02/2018
Last updated
06/08/2018
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