Provider Demographics
NPI:1811500887
Name:WALTERS, JENNIFER J (ND)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:WALTERS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23111 105TH ST SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-7809
Mailing Address - Country:US
Mailing Address - Phone:425-225-5310
Mailing Address - Fax:833-783-1742
Practice Address - Street 1:3922 148TH ST SE STE 203
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-4752
Practice Address - Country:US
Practice Address - Phone:425-225-5310
Practice Address - Fax:833-783-1742
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAND61107841175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath