Provider Demographics
NPI:1619016243
Name:WELLIVER, NANCY COLLETTE (ND)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:COLLETTE
Last Name:WELLIVER
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 1:24000 49TH PL W
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5604
Mailing Address - Country:US
Mailing Address - Phone:425-640-7525
Mailing Address - Fax:
Practice Address - Street 1:3670 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8004
Practice Address - Country:US
Practice Address - Phone:206-834-4100
Practice Address - Fax:206-834-4194
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000683175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath