Provider Demographics
NPI:1659144319
Name:ANTHONY, BROOKE MONET (ND)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:MONET
Last Name:ANTHONY
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 1:3521 S LESCHI PL APT 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2638
Mailing Address - Country:US
Mailing Address - Phone:936-446-7661
Mailing Address - Fax:
Practice Address - Street 1:2825 EASTLAKE AVE E STE 115
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3084
Practice Address - Country:US
Practice Address - Phone:206-420-1321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61497578175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath