Provider Demographics
NPI:1669090940
Name:LIMBURG, SAYRE (ND)
Entity type:Individual
Prefix:
First Name:SAYRE
Middle Name:
Last Name:LIMBURG
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 1:4203 OLYMPUS DR NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-8315
Mailing Address - Country:US
Mailing Address - Phone:603-748-3009
Mailing Address - Fax:
Practice Address - Street 1:4203 OLYMPUS DR NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-8315
Practice Address - Country:US
Practice Address - Phone:360-598-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61045359175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1669090940Medicaid