Healthcare Provider Details

I. General information

NPI: 1508905894
Provider Name (Legal Business Name): JEAN LAWLER N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15650 NE 24TH ST SUITE C-2
BELLEVUE WA
98008-2460
US

IV. Provider business mailing address

44531 SE 148TH ST
NORTH BEND WA
98045-9761
US

V. Phone/Fax

Practice location:
  • Phone: 425-466-8202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT 1376
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: