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General NPI Number Information
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NPI Number | 1245507920
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Entity Type | Individual
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Provider Name | VANESSA DZIUBA WILKIE ND
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Gender | Female
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 2025 112TH AVE NE BLDG 2, SUITE 300
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City | BELLEVUE
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State | WA
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Zip | 98004
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Country | US
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Telephone | 425-452-9366
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Fax | 425-452-5683
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Provider Business Mailing Address
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Address Line | 2025 112TH AVE NE BLDG 2, SUITE 300
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City | BELLEVUE
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State | WA
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Zip | 98004
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Country | US
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Telephone | 425-452-9366
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Fax | 425-452-5683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT60256856
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License Number State | WA
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