Provider Demographics
NPI:1396410569
Name:BARAN-MICKLE, MATTHEW (ND)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:BARAN-MICKLE
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 1:21529 INDIANOLA RD NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18978 FRONT ST NE STE 150
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7353
Practice Address - Country:US
Practice Address - Phone:360-209-5585
Practice Address - Fax:877-349-6941
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath