Provider Demographics
NPI:1982826723
Name:COSTARELLA, LINDA ANN (ND)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:COSTARELLA
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 1:2405 NE 17TH PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-2306
Mailing Address - Country:US
Mailing Address - Phone:206-615-2646
Mailing Address - Fax:206-615-2097
Practice Address - Street 1:2405 NE 17TH PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-2306
Practice Address - Country:US
Practice Address - Phone:206-615-2646
Practice Address - Fax:206-615-2097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00000616175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath