Provider Demographics
NPI:1558683698
Name:WAHLER, VENESSA L (ND)
Entity Type:Individual
Prefix:DR
First Name:VENESSA
Middle Name:L
Last Name:WAHLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:VENESSA
Other - Middle Name:L
Other - Last Name:THERIAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:1620 BROADWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2556
Mailing Address - Country:US
Mailing Address - Phone:206-420-6701
Mailing Address - Fax:206-453-4170
Practice Address - Street 1:1620 BROADWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2556
Practice Address - Country:US
Practice Address - Phone:206-420-6701
Practice Address - Fax:206-453-4170
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60013242175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath