Healthcare Provider Details

I. General information

NPI: 1568786887
Provider Name (Legal Business Name): MARY CAROL NACHTIGAL RN, ARNP, ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2010
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 26TH AVE S
SEATTLE WA
98144-5339
US

IV. Provider business mailing address

6047 S ROXBURY ST
SEATTLE WA
98118-5944
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-7464
  • Fax:
Mailing address:
  • Phone: 206-854-3271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00172351
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60109747
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60108244
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: