Provider Demographics
NPI:1013766245
Name:ANZALONE, JUNIPER R (ND)
Entity type:Individual
Prefix:
First Name:JUNIPER
Middle Name:R
Last Name:ANZALONE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 NE 189TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-2235
Mailing Address - Country:US
Mailing Address - Phone:206-999-3028
Mailing Address - Fax:
Practice Address - Street 1:816 NE 189TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-2235
Practice Address - Country:US
Practice Address - Phone:206-999-3028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61548521175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty