Provider Demographics
NPI:1508216011
Name:STANIEK, CANDICE (ND)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:STANIEK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12828 NEWCASTLE WAY
Mailing Address - Street 2:APT 103
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1335
Mailing Address - Country:US
Mailing Address - Phone:425-209-0607
Mailing Address - Fax:
Practice Address - Street 1:12828 NEWCASTLE WAY
Practice Address - Street 2:APT 103
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98056-1335
Practice Address - Country:US
Practice Address - Phone:425-209-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60648856175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath