Healthcare Provider Details

I. General information

NPI: 1063695047
Provider Name (Legal Business Name): EMILY M GONZALEZ ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7337 35TH AVE NE
SEATTLE WA
98115-5918
US

IV. Provider business mailing address

6834 37TH AVE NE
SEATTLE WA
98115-7434
US

V. Phone/Fax

Practice location:
  • Phone: 206-351-5135
  • Fax: 206-523-5566
Mailing address:
  • Phone: 206-351-5135
  • Fax: 206-523-5566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001604
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: