Provider Demographics
NPI:1457827560
Name:WATTLES, KALEA ROSE (ND)
Entity Type:Individual
Prefix:DR
First Name:KALEA
Middle Name:ROSE
Last Name:WATTLES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:KALEA
Other - Middle Name:
Other - Last Name:MCBRIDE-CARBARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:560 SPOONER RD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-9241
Mailing Address - Country:US
Mailing Address - Phone:206-920-4384
Mailing Address - Fax:
Practice Address - Street 1:560 SPOONER RD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-9241
Practice Address - Country:US
Practice Address - Phone:206-920-4384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60857290175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath