Provider Demographics
NPI:1831590793
Name:KRONENBERG, DESIREE (ND)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:
Last Name:KRONENBERG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:
Other - Last Name:STAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:3154 E 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4852
Mailing Address - Country:US
Mailing Address - Phone:509-315-8784
Mailing Address - Fax:
Practice Address - Street 1:3154 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4852
Practice Address - Country:US
Practice Address - Phone:509-724-0292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60491631175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath