Provider Demographics
NPI:1801149059
Name:ROODVOETS, CHELSEA (NMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:ROODVOETS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 E BASELINE RD STE 121
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2690
Mailing Address - Country:US
Mailing Address - Phone:480-287-2588
Mailing Address - Fax:
Practice Address - Street 1:3651 E BASELINE RD STE 121
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2690
Practice Address - Country:US
Practice Address - Phone:480-719-5119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1827175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ19-1827OtherNATUROPATHIC MEDICAL LICENSE