Provider Demographics
NPI:1003388596
Name:SPALDING, MARIKO O (ND, LMT)
Entity Type:Individual
Prefix:
First Name:MARIKO
Middle Name:O
Last Name:SPALDING
Suffix:
Gender:F
Credentials:ND, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10512 NE 68 TH STREET
Mailing Address - Street 2:SUITE C-102, OFFICE D
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7192
Mailing Address - Country:US
Mailing Address - Phone:206-249-9136
Mailing Address - Fax:206-536-2190
Practice Address - Street 1:10512 NE 68TH ST STE C102
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7002
Practice Address - Country:US
Practice Address - Phone:206-249-9136
Practice Address - Fax:206-536-2190
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
WAMA60898168225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist