Healthcare Provider Details

I. General information

NPI: 1659428779
Provider Name (Legal Business Name): SEAN PATRICK CONGDON N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 STONE WAY N
SEATTLE WA
98103-8004
US

IV. Provider business mailing address

424 24TH AVE E
SEATTLE WA
98112-4714
US

V. Phone/Fax

Practice location:
  • Phone: 206-834-4100
  • Fax: 206-834-4131
Mailing address:
  • Phone: 206-595-0144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001043
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: