Provider Demographics
NPI:1235869074
Name:HERNANDEZ, LOIS ANTONIA (ND)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:ANTONIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18920 68TH AVE NE APT F106
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-2657
Mailing Address - Country:US
Mailing Address - Phone:205-765-8523
Mailing Address - Fax:
Practice Address - Street 1:18920 68TH AVE NE APT F106
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-2657
Practice Address - Country:US
Practice Address - Phone:205-765-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath