Provider Demographics
NPI:1821351917
Name:DAVID L GRAVES
Entity Type:Organization
Organization Name:DAVID L GRAVES
Other - Org Name:NATUROPATHIC MED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LYLE
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:509-413-1530
Mailing Address - Street 1:2607 S SOUTHEAST BLVD
Mailing Address - Street 2:B111
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4942
Mailing Address - Country:US
Mailing Address - Phone:509-413-1530
Mailing Address - Fax:
Practice Address - Street 1:2607 S SOUTHEAST BLVD
Practice Address - Street 2:B111
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4942
Practice Address - Country:US
Practice Address - Phone:509-413-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60161938175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty