Provider Demographics
NPI:1487873394
Name:ROBERTS, NANCY A (NATUROPATH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NATUROPATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14546 GREENWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6426
Mailing Address - Country:US
Mailing Address - Phone:206-362-3250
Mailing Address - Fax:206-440-0932
Practice Address - Street 1:14546 GREENWOOD AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-6426
Practice Address - Country:US
Practice Address - Phone:206-362-3250
Practice Address - Fax:206-440-0932
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000528175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath