Provider Demographics
NPI:1568531291
Name:SPENCER, NATHAN (ND)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:SPENCER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 214TH AVE E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6245
Mailing Address - Country:US
Mailing Address - Phone:253-862-3501
Mailing Address - Fax:253-862-3509
Practice Address - Street 1:2722 214TH AVE E
Practice Address - Street 2:
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391-6245
Practice Address - Country:US
Practice Address - Phone:253-862-3501
Practice Address - Fax:253-862-3509
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1432175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath