Provider Demographics
NPI:1629481585
Name:CONNER, WILLIAM L JR (ND)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:CONNER
Suffix:JR
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 1:15327 111TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-4821
Mailing Address - Country:US
Mailing Address - Phone:630-956-8112
Mailing Address - Fax:
Practice Address - Street 1:15327 111TH AVE NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-4821
Practice Address - Country:US
Practice Address - Phone:630-956-8112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61363565175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath