Provider Demographics
NPI:1134560717
Name:NELSON, JENNIFER ANNE (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:NELSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6800 E GREEN LAKE WAY N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5489
Mailing Address - Country:US
Mailing Address - Phone:206-706-0306
Mailing Address - Fax:206-706-4772
Practice Address - Street 1:6800 E GREEN LAKE WAY N
Practice Address - Street 2:SUITE 250
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5489
Practice Address - Country:US
Practice Address - Phone:206-706-0306
Practice Address - Fax:206-706-4772
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANATU.NT.60392617175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath