Provider Demographics
NPI:1295193993
Name:KING, STEPHEN JAMES (ND)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
Last Name:KING
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 1:3711 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3909
Mailing Address - Country:US
Mailing Address - Phone:206-522-0488
Mailing Address - Fax:
Practice Address - Street 1:3711 NE 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3909
Practice Address - Country:US
Practice Address - Phone:206-522-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA413175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA413OtherLICENSE