Provider Demographics
NPI:1942775945
Name:ROBERTSON, LENA MAE (ND)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:MAE
Last Name:ROBERTSON
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 1:2 GRAY BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-7771
Mailing Address - Country:US
Mailing Address - Phone:253-886-8763
Mailing Address - Fax:
Practice Address - Street 1:1333 KING ST STE A
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6267
Practice Address - Country:US
Practice Address - Phone:253-886-8763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60896179175F00000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath