Provider Demographics
NPI:1689737330
Name:DOCERE CENTER FOR NATURAL MEDICINE
Entity Type:Organization
Organization Name:DOCERE CENTER FOR NATURAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHENELLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LM
Authorized Official - Phone:206-706-0306
Mailing Address - Street 1:5343 TALLMAN AVE NW
Mailing Address - Street 2:STE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3931
Mailing Address - Country:US
Mailing Address - Phone:206-706-0306
Mailing Address - Fax:206-706-4772
Practice Address - Street 1:5343 TALLMAN AVE NW
Practice Address - Street 2:STE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3931
Practice Address - Country:US
Practice Address - Phone:206-706-0306
Practice Address - Fax:206-706-4772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001436175F00000X
WAMW00000303176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
Not Answered176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7131816Medicaid
WA0601Medicare UPIN