Provider Demographics
NPI:1841695798
Name:AYERS, WADE ROBERT (ND)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:ROBERT
Last Name:AYERS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BETHEL AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5215
Mailing Address - Country:US
Mailing Address - Phone:360-602-2806
Mailing Address - Fax:360-397-0462
Practice Address - Street 1:205 BETHEL AVENUE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5215
Practice Address - Country:US
Practice Address - Phone:360-602-2806
Practice Address - Fax:360-397-0462
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANATU.NT.60390143175F00000X
WANT60390143175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath