Provider Demographics
NPI:1568775518
Name:WHEELER, BARRY MICHAEL (ND)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MICHAEL
Last Name:WHEELER
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 1:11903 NE 128TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7209
Mailing Address - Country:US
Mailing Address - Phone:425-820-3800
Mailing Address - Fax:425-820-3803
Practice Address - Street 1:11911 NE 132ND ST STE 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-2900
Practice Address - Country:US
Practice Address - Phone:206-960-4770
Practice Address - Fax:866-998-1837
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60120417175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath