Provider Demographics
NPI:1245788199
Name:SZYMCZAK, EDWARD (ND)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:SZYMCZAK
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 LAKE LANGLOIS RD NE
Mailing Address - Street 2:
Mailing Address - City:CARNATION
Mailing Address - State:WA
Mailing Address - Zip Code:98014-6007
Mailing Address - Country:US
Mailing Address - Phone:425-333-4600
Mailing Address - Fax:425-333-4646
Practice Address - Street 1:4563 TOLT AVENUE
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014
Practice Address - Country:US
Practice Address - Phone:425-333-4600
Practice Address - Fax:425-333-4646
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175F00000X
MN1069175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath