Provider Demographics
NPI:1891336624
Name:DE LOMBAERT, ROSALIE KATHLEEN MARIE (ND)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:KATHLEEN MARIE
Last Name:DE LOMBAERT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22635 NE MARKETPLACE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5886
Mailing Address - Country:US
Mailing Address - Phone:425-949-5961
Mailing Address - Fax:
Practice Address - Street 1:22635 NE MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5885
Practice Address - Country:US
Practice Address - Phone:425-949-5961
Practice Address - Fax:425-949-5962
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath