Healthcare Provider Details

I. General information

NPI: 1386198703
Provider Name (Legal Business Name): ABIGAIL NELSON N.D., L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EASTLAKE AVE E
SEATTLE WA
98102-3707
US

IV. Provider business mailing address

1500 EASTLAKE AVE E
SEATTLE WA
98102-3707
US

V. Phone/Fax

Practice location:
  • Phone: 206-861-8300
  • Fax: 206-861-8305
Mailing address:
  • Phone: 206-861-8300
  • Fax: 206-861-8305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60658363
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60738539
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: