Provider Demographics
NPI:1790392983
Name:BUECHEL, KELLY (ND)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:BUECHEL
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 1:1227 N ALLEN PLACE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-624-6627
Mailing Address - Fax:206-525-5933
Practice Address - Street 1:1227 N ALLEN PL
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7412
Practice Address - Country:US
Practice Address - Phone:206-624-6627
Practice Address - Fax:206-525-5933
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61125611171100000X
WA61098789175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist