Provider Demographics
NPI:1578651238
Name:PHILLIPS, CYNTHIA KAREN (ND)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:KAREN
Last Name:PHILLIPS
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 1:5415 S HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2139
Mailing Address - Country:US
Mailing Address - Phone:206-723-4544
Mailing Address - Fax:
Practice Address - Street 1:726 BROADWAY
Practice Address - Street 2:STE 301
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4378
Practice Address - Country:US
Practice Address - Phone:206-726-0034
Practice Address - Fax:206-726-9434
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000671175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath