Provider Demographics
NPI:1891049227
Name:FLEETWOOD, CHRISTIE FAYE (ND, RPH)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:FAYE
Last Name:FLEETWOOD
Suffix:
Gender:F
Credentials:ND, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3629
Mailing Address - Country:US
Mailing Address - Phone:206-525-8015
Mailing Address - Fax:206-525-8014
Practice Address - Street 1:5312 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3629
Practice Address - Country:US
Practice Address - Phone:206-525-8015
Practice Address - Fax:206-525-8014
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001374175F00000X
VA0202009377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No183500000XPharmacy Service ProvidersPharmacist