Provider Demographics
NPI:1780075689
Name:PALLESEN, SYDNEY ANN (ND)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ANN
Last Name:PALLESEN
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 1:5512 NE 109TH CT
Mailing Address - Street 2:SUITE I
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6175
Mailing Address - Country:US
Mailing Address - Phone:302-559-1444
Mailing Address - Fax:
Practice Address - Street 1:5512 NE 109TH CT
Practice Address - Street 2:SUITE I
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6175
Practice Address - Country:US
Practice Address - Phone:360-798-5704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath