Healthcare Provider Details

I. General information

NPI: 1578651238
Provider Name (Legal Business Name): CYNTHIA KAREN PHILLIPS N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 BROADWAY STE 301
SEATTLE WA
98122-4378
US

IV. Provider business mailing address

5415 S HUDSON ST
SEATTLE WA
98118-2139
US

V. Phone/Fax

Practice location:
  • Phone: 206-726-0034
  • Fax: 206-726-9434
Mailing address:
  • Phone: 206-723-4544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00000671
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: