Provider Demographics
NPI:1447610670
Name:CARLSON, JONATHAN JAMES (ND)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JAMES
Last Name:CARLSON
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 1:1108 11TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6623
Mailing Address - Country:US
Mailing Address - Phone:360-605-0444
Mailing Address - Fax:
Practice Address - Street 1:1108 11TH ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6623
Practice Address - Country:US
Practice Address - Phone:360-605-0444
Practice Address - Fax:360-605-0279
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60633670175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath