Provider Demographics
NPI:1871856187
Name:MEAD, ADEOLA MARY (ND)
Entity Type:Individual
Prefix:DR
First Name:ADEOLA
Middle Name:MARY
Last Name:MEAD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:ADEOLA
Other - Middle Name:MARY
Other - Last Name:EPEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:5914 8TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2809
Mailing Address - Country:US
Mailing Address - Phone:510-778-5207
Mailing Address - Fax:844-595-7585
Practice Address - Street 1:8012 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3601
Practice Address - Country:US
Practice Address - Phone:206-707-9366
Practice Address - Fax:844-595-7585
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-530175F00000X
WA60059893175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath