Provider Demographics
NPI:1780710715
Name:COLSTON, LETITIA L (ND)
Entity type:Individual
Prefix:DR
First Name:LETITIA
Middle Name:L
Last Name:COLSTON
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 1:2014 E MERCER ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4031
Mailing Address - Country:US
Mailing Address - Phone:206-769-6762
Mailing Address - Fax:
Practice Address - Street 1:4852 37TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1719
Practice Address - Country:US
Practice Address - Phone:206-769-6762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001588175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath