Provider Demographics
NPI:1275846891
Name:DAZEY, JENN (ND)
Entity Type:Individual
Prefix:DR
First Name:JENN
Middle Name:
Last Name:DAZEY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13732 WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9769
Mailing Address - Country:US
Mailing Address - Phone:206-909-6376
Mailing Address - Fax:360-805-0380
Practice Address - Street 1:13732 WAGNER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-9769
Practice Address - Country:US
Practice Address - Phone:206-909-6376
Practice Address - Fax:360-805-0380
Is Sole Proprietor?:No
Enumeration Date:2010-07-24
Last Update Date:2010-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60061990175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath