Healthcare Provider Details

I. General information

NPI: 1942847934
Provider Name (Legal Business Name): BLAKE LANGLEY ND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 FAIRVIEW AVE N
SEATTLE WA
98109-4433
US

IV. Provider business mailing address

125A 20TH AVE E
SEATTLE WA
98112-5311
US

V. Phone/Fax

Practice location:
  • Phone: 206-667-3481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4267
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: