Provider Demographics
NPI:1134456718
Name:GLEISNER, DEBORAH ANNE (ND, LM, CPM)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANNE
Last Name:GLEISNER
Suffix:
Gender:F
Credentials:ND, LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22725 44TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4500
Mailing Address - Country:US
Mailing Address - Phone:425-678-9070
Mailing Address - Fax:425-420-2941
Practice Address - Street 1:22725 44TH AVE W STE 101
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-4500
Practice Address - Country:US
Practice Address - Phone:425-678-9070
Practice Address - Fax:425-420-2941
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-377175F00000X
CALM259176B00000X
WAW60123752176B00000X
WANT60528476175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife