Provider Demographics
NPI:1821134602
Name:SPEIDEL, STEPHEN DOUGLAS (ND)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DOUGLAS
Last Name:SPEIDEL
Suffix:
Gender:M
Credentials:ND
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Other - Credentials:
Mailing Address - Street 1:17791 FJORD DR NE
Mailing Address - Street 2:SUITE J-160
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8481
Mailing Address - Country:US
Mailing Address - Phone:360-697-2122
Mailing Address - Fax:360-697-4617
Practice Address - Street 1:19586 10TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7332
Practice Address - Country:US
Practice Address - Phone:360-697-2122
Practice Address - Fax:360-697-4617
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA447175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath