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NPI Code Detail

MEDICARE: DR. JENNIFER BROOKE HOLDORF N.D.

MEDICARE: DR. JENNIFER BROOKE HOLDORF N.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175F00000XNaturopath5.000450CT

General Provider Information

NPI Number : 1720380686
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER BROOKE HOLDORF N.D.
Provider Business Mailing Address
First Line : 2705 E MADISON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4738
Country : US
Telephone Number : 206-328-7929
Fax Number : 206-328-6066
Provider Business Practice Location Address
First Line : 2705 E MADISON ST
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4738
Country : US
Telephone Number : 206-328-7929
Fax Number : 206-328-6066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2010
Last Update Date : 07/21/2022

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