Healthcare Provider Details

I. General information

NPI: 1003726514
Provider Name (Legal Business Name): OPHIDIA INTEGRATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 NE 20TH ST STE G
BELLEVUE WA
98005-4901
US

IV. Provider business mailing address

95 MOLLY SUPPLE HILL RD
MONTPELIER VT
05602-9525
US

V. Phone/Fax

Practice location:
  • Phone: 908-752-5856
  • Fax: 800-392-4284
Mailing address:
  • Phone: 908-752-5856
  • Fax: 800-392-4284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ATARA JAFFE
Title or Position: NATUROPATHIC DOCTOR
Credential: ND
Phone: 908-752-5856