Provider Demographics
NPI:1467756387
Name:BUETTNER, REBECCA ALLISON (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ALLISON
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 GOFF RD
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-9006
Mailing Address - Country:US
Mailing Address - Phone:206-930-5985
Mailing Address - Fax:206-525-8013
Practice Address - Street 1:5322 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3629
Practice Address - Country:US
Practice Address - Phone:206-525-8012
Practice Address - Fax:206-525-8013
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60194265171100000X
WANT60194269175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist