Provider Demographics
NPI:1578743498
Name:BISHOP, NITA ELLEN (ND)
Entity Type:Individual
Prefix:DR
First Name:NITA
Middle Name:ELLEN
Last Name:BISHOP
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 1:13501 100TH AVE NE
Mailing Address - Street 2:#5091
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034
Mailing Address - Country:US
Mailing Address - Phone:206-699-1550
Mailing Address - Fax:360-691-6451
Practice Address - Street 1:8529 124TH AVE NE
Practice Address - Street 2:#5091
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033
Practice Address - Country:US
Practice Address - Phone:206-699-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT1181175F00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No207N00000XAllopathic & Osteopathic PhysiciansDermatology