Provider Demographics
NPI:1174641310
Name:MUNRO, BROOK ALEXANDRIA (ND)
Entity Type:Individual
Prefix:
First Name:BROOK
Middle Name:ALEXANDRIA
Last Name:MUNRO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:BROOK
Other - Middle Name:
Other - Last Name:SCRONCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7411 HENDERSON CT SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6835
Mailing Address - Country:US
Mailing Address - Phone:206-406-9778
Mailing Address - Fax:
Practice Address - Street 1:1530 S UNION AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1954
Practice Address - Country:US
Practice Address - Phone:253-752-2558
Practice Address - Fax:253-759-6460
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001481175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath