Healthcare Provider Details

I. General information

NPI: 1164149480
Provider Name (Legal Business Name): ATARA JAFFE ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 EASTLAKE AVE E STE 115
SEATTLE WA
98102-3084
US

IV. Provider business mailing address

2825 EASTLAKE AVE E STE 115
SEATTLE WA
98102-3084
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-1321
  • Fax: 833-584-0067
Mailing address:
  • Phone: 206-420-1321
  • Fax: 833-584-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT61366665
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: