Provider Demographics
NPI:1073890612
Name:BOKMAN, ELISHA FAYE (ND)
Entity Type:Individual
Prefix:DR
First Name:ELISHA
Middle Name:FAYE
Last Name:BOKMAN
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 1:918 N 200TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3104
Mailing Address - Country:US
Mailing Address - Phone:646-263-8008
Mailing Address - Fax:
Practice Address - Street 1:918 N 200TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3104
Practice Address - Country:US
Practice Address - Phone:646-263-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60251745175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath