Provider Demographics
NPI:1740657642
Name:MILLER AFSARI, REBEKAH JACQUELINE (ND, LMP)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JACQUELINE
Last Name:MILLER AFSARI
Suffix:
Gender:F
Credentials:ND, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16324 84TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-1627
Mailing Address - Country:US
Mailing Address - Phone:765-967-2442
Mailing Address - Fax:
Practice Address - Street 1:16324 84TH AVE NE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-1627
Practice Address - Country:US
Practice Address - Phone:765-967-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60952481175F00000X
WAMA60431729225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist