Provider Demographics
NPI:1619112760
Name:CAPORICCIO, JUDITH KAYE (ND)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:KAYE
Last Name:CAPORICCIO
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 1:1601 COLUMBIA PARK TRL
Mailing Address - Street 2:103
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4772
Mailing Address - Country:US
Mailing Address - Phone:509-736-6311
Mailing Address - Fax:509-736-6336
Practice Address - Street 1:1601 COLUMBIA PARK TRL
Practice Address - Street 2:103
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4772
Practice Address - Country:US
Practice Address - Phone:509-736-6311
Practice Address - Fax:509-736-6336
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60057466175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath