Healthcare Provider Details

I. General information

NPI: 1366357196
Provider Name (Legal Business Name): JENNA STEPHANOFF ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 FREMONT AVE N # 181
SEATTLE WA
98103-8814
US

IV. Provider business mailing address

3518 FREMONT AVE N # 181
SEATTLE WA
98103-8814
US

V. Phone/Fax

Practice location:
  • Phone: 206-705-3956
  • Fax:
Mailing address:
  • Phone: 206-705-3956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: