Healthcare Provider Details

I. General information

NPI: 1538073028
Provider Name (Legal Business Name): MARIAH JASMINE EMERSON ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAH JASMINE ASHLEY-EMERSON ND

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 CRENSHAW BLVD APT 318
LOS ANGELES CA
90043-1238
US

IV. Provider business mailing address

814 6TH AVE S
SEATTLE WA
98134-1304
US

V. Phone/Fax

Practice location:
  • Phone: 706-615-0189
  • Fax:
Mailing address:
  • Phone: 706-615-0189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: