Provider Demographics
NPI:1770669475
Name:JANEL, KATHLEEN JOAN (ND)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:JOAN
Last Name:JANEL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:315 LINCOLN AVE #1
Mailing Address - Street 2:SUITE H
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275
Mailing Address - Country:US
Mailing Address - Phone:425-423-0878
Mailing Address - Fax:425-423-0757
Practice Address - Street 1:315 LINCOLN AVE #1
Practice Address - Street 2:SUITE H
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275
Practice Address - Country:US
Practice Address - Phone:425-423-0878
Practice Address - Fax:425-423-0757
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001272175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2094JAOtherBLUE SHIELD