Provider Demographics
NPI:1124023007
Name:NOLTING, MARK HARRISON (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HARRISON
Last Name:NOLTING
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:714 BIRCH PL
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4687
Mailing Address - Country:US
Mailing Address - Phone:452-775-7267
Mailing Address - Fax:425-776-8873
Practice Address - Street 1:7935 216TH ST SW
Practice Address - Street 2:STE E
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7941
Practice Address - Country:US
Practice Address - Phone:425-672-2113
Practice Address - Fax:425-776-8873
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA28171100000X
WA513175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath