Provider Demographics
NPI:1043359169
Name:VARON, MICHAEL BRUCE (RPH, ND)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRUCE
Last Name:VARON
Suffix:
Gender:M
Credentials:RPH, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4837 S GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2839
Mailing Address - Country:US
Mailing Address - Phone:206-722-8985
Mailing Address - Fax:206-325-5016
Practice Address - Street 1:1600 E OLIVE ST
Practice Address - Street 2:BUILDING D
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2735
Practice Address - Country:US
Practice Address - Phone:425-835-7110
Practice Address - Fax:206-325-5016
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000600175F00000X
WAPH00011128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered183500000XPharmacy Service ProvidersPharmacist