Nathan Michael Andrew Black
Religious Nonmedical Practitioner in Seattle, WA. Individual provider (NPI-1).
NPI number1164080396
StatusActive
Last updated in NPPESJun 3, 2019
Details
- NPI
- 1164080396
- Entity type
- Individual (NPI-1)
- Name
- Nathan Michael Andrew Black
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2019
- Last updated
- Jun 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374K00000X | Religious Nonmedical Practitioner | – | – | Yes |
Practice location
1660 S Columbian WaySeattle, WA 98108-1532
Phone 206-764-2023
Mailing address
1660 S Columbian WaySeattle, WA 98108-1532
Phone 206-764-2023
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