Healthcare Provider Details

I. General information

NPI: 1306117775
Provider Name (Legal Business Name): LEAH MITCHELL N.D., L.M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 NE 68TH STREET
SEATTLE WA
98115
US

IV. Provider business mailing address

853 NE 68TH STREET
SEATTLE WA
98115
US

V. Phone/Fax

Practice location:
  • Phone: 206-284-6040
  • Fax: 206-284-7943
Mailing address:
  • Phone: 206-284-6040
  • Fax: 206-284-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: