Healthcare Provider Details

I. General information

NPI: 1659144319
Provider Name (Legal Business Name): BROOKE MONET ANTHONY ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 EASTLAKE AVE E STE 115
SEATTLE WA
98102-3084
US

IV. Provider business mailing address

3521 S LESCHI PL APT 1
SEATTLE WA
98144-2638
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-1321
  • Fax:
Mailing address:
  • Phone: 936-446-7661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT61497578
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: