Provider Demographics
NPI:1649526963
Name:KALTUNAS, JENNIFER (ND, EAMP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KALTUNAS
Suffix:
Gender:F
Credentials:ND, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12304 32ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5506
Mailing Address - Country:US
Mailing Address - Phone:206-588-0936
Mailing Address - Fax:206-557-4768
Practice Address - Street 1:12304 32ND AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5506
Practice Address - Country:US
Practice Address - Phone:206-588-0936
Practice Address - Fax:206-557-4768
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60271379171100000X
WANT60271374175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist