Provider Demographics
NPI:1447794250
Name:DRAKE, JAMES (LMP, ND)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DRAKE
Suffix:
Gender:M
Credentials:LMP, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 HOYT AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3551
Mailing Address - Country:US
Mailing Address - Phone:425-293-0107
Mailing Address - Fax:425-293-0329
Practice Address - Street 1:2808 HOYT AVE
Practice Address - Street 2:STE 201
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3551
Practice Address - Country:US
Practice Address - Phone:425-293-0107
Practice Address - Fax:425-293-0329
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60754100175F00000X
WA60432848171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171W00000XOther Service ProvidersContractor