Healthcare Provider Details

I. General information

NPI: 1750449021
Provider Name (Legal Business Name): BROOKE AZIE-RENTZ N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22635 NE MARKETPLACE DR SUITE 130
REDMOND WA
98053-5885
US

IV. Provider business mailing address

22635 NE MARKETPLACE DR SUITE 130
REDMOND WA
98053-5885
US

V. Phone/Fax

Practice location:
  • Phone: 425-949-5961
  • Fax: 425-949-5962
Mailing address:
  • Phone: 425-949-5961
  • Fax: 425-949-5962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT1446
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: