Provider Demographics
NPI:1548475221
Name:REAY, BONNIE SUE (ND)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:SUE
Last Name:REAY
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 1:108 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-1139
Mailing Address - Country:US
Mailing Address - Phone:509-260-1226
Mailing Address - Fax:509-674-2833
Practice Address - Street 1:108 W 2ND ST
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-1139
Practice Address - Country:US
Practice Address - Phone:509-260-1226
Practice Address - Fax:509-674-2833
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000863175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath