Provider Demographics
NPI:1679691166
Name:DAGENAIS, LINDA LISE-MARIE (ND)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LISE-MARIE
Last Name:DAGENAIS
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 1:5600 KIRKWOOD PL N STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5964
Mailing Address - Country:US
Mailing Address - Phone:206-841-0588
Mailing Address - Fax:
Practice Address - Street 1:5600 KIRKWOOD PL N STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5964
Practice Address - Country:US
Practice Address - Phone:206-903-6111
Practice Address - Fax:206-903-6125
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT948175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath