Healthcare Provider Details

I. General information

NPI: 1003240920
Provider Name (Legal Business Name): ASHLEY SKLUZACEK ND, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY RAICHE ND, LM

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PACIFIC AVE STE 501
EVERETT WA
98201-4189
US

IV. Provider business mailing address

15650 NE 24TH ST STE A
BELLEVUE WA
98008-2460
US

V. Phone/Fax

Practice location:
  • Phone: 425-258-7555
  • Fax:
Mailing address:
  • Phone: 425-505-2745
  • Fax: 425-505-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60404848
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60402520
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: