Provider Demographics
NPI:1609375120
Name:ATTWOOD, MARY ELIZABETH BROWNE (ND)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH BROWNE
Last Name:ATTWOOD
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 1:205 CLARK PL SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4062
Mailing Address - Country:US
Mailing Address - Phone:360-570-0401
Mailing Address - Fax:360-570-2060
Practice Address - Street 1:205 CLARK PL SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4062
Practice Address - Country:US
Practice Address - Phone:360-570-0401
Practice Address - Fax:360-570-2060
Is Sole Proprietor?:No
Enumeration Date:2018-02-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61324855175F00000X
OR4213175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500753345Medicaid