Provider Demographics
NPI:1336597566
Name:GAWURA, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:GAWURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 E MAPLE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5755
Mailing Address - Country:US
Mailing Address - Phone:360-738-3230
Mailing Address - Fax:
Practice Address - Street 1:1313 E MAPLE ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5755
Practice Address - Country:US
Practice Address - Phone:360-738-3230
Practice Address - Fax:360-738-4955
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
WA175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other