Provider Demographics
NPI:1003349200
Name:ADDABBO, COURTNEY ELIZABETH BURKHART (ND)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH BURKHART
Last Name:ADDABBO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ELIZABETH
Other - Last Name:BURKHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1210 N 152ND ST UNIT 501
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-6343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:317 4TH ST NW
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-4313
Practice Address - Country:US
Practice Address - Phone:425-441-3330
Practice Address - Fax:253-466-3139
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60740400175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath