Provider Demographics
NPI:1194023812
Name:SACKSTEDER, ANNETTE MARIE (ND, EAMP)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:MARIE
Last Name:SACKSTEDER
Suffix:
Gender:F
Credentials:ND, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 603
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-726-0034
Mailing Address - Fax:206-726-9434
Practice Address - Street 1:1600 E JEFFERSON ST
Practice Address - Street 2:SUITE 603
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5698
Practice Address - Country:US
Practice Address - Phone:206-726-0034
Practice Address - Fax:206-726-9434
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60178327171100000X
WANT 60178341175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist