Provider Demographics
NPI:1861533218
Name:BOOKER, JENNIFER L (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:BOOKER
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:P.O. BOX 4025
Mailing Address - Street 2:448 SUSEX AVE. STE. 2
Mailing Address - City:TENINO
Mailing Address - State:WA
Mailing Address - Zip Code:98589
Mailing Address - Country:US
Mailing Address - Phone:360-264-4567
Mailing Address - Fax:360-264-4511
Practice Address - Street 1:448 SUSSEX AVE EAST
Practice Address - Street 2:SUITE 2
Practice Address - City:TENINO
Practice Address - State:WA
Practice Address - Zip Code:98589
Practice Address - Country:US
Practice Address - Phone:360-264-4567
Practice Address - Fax:360-264-4511
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000625175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath