Healthcare Provider Details

I. General information

NPI: 1578477642
Provider Name (Legal Business Name): CARLEY J PONCHETTI ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 CALIFORNIA AVE SW STE 101
SEATTLE WA
98136-1562
US

IV. Provider business mailing address

5410 CALIFORNIA AVE SW STE 101
SEATTLE WA
98136-1562
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-8383
  • Fax:
Mailing address:
  • Phone: 206-486-8383
  • Fax: 206-312-8594

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: