Provider Demographics
NPI:1881831816
Name:WATERLEAF NATUROPATHIC MEDICINE
Entity Type:Organization
Organization Name:WATERLEAF NATUROPATHIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:B
Authorized Official - Last Name:COLWELL
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-631-1131
Mailing Address - Street 1:2901 NE BLAKELEY ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3164
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 NE BLAKELEY ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3164
Practice Address - Country:US
Practice Address - Phone:206-631-1131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001512261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service