Healthcare Provider Details

I. General information

NPI: 1881831816
Provider Name (Legal Business Name): WATERLEAF NATUROPATHIC MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 NE BLAKELEY ST SUITE 3B
SEATTLE WA
98105-3164
US

IV. Provider business mailing address

2901 NE BLAKELEY ST SUITE 3B
SEATTLE WA
98105-3164
US

V. Phone/Fax

Practice location:
  • Phone: 206-631-1131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberNT00001512
License Number StateWA

VIII. Authorized Official

Name: DR. EMILY B COLWELL
Title or Position: NATUROPATHIC PHYSICIAN
Credential: ND
Phone: 206-631-1131