Provider Demographics
NPI:1881042901
Name:SQUIRES, CARLEY (ND, LAC, EAMP)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:ND, LAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 14TH AVE NW STE 2
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3723
Mailing Address - Country:US
Mailing Address - Phone:206-919-0175
Mailing Address - Fax:
Practice Address - Street 1:5600 14TH AVE NW STE 2
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3723
Practice Address - Country:US
Practice Address - Phone:206-919-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist