Provider Demographics
NPI:1346725652
Name:SEIBERLICH, AMY MARIE (ND)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:SEIBERLICH
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 1:828 ULERY ST SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1347
Mailing Address - Country:US
Mailing Address - Phone:206-992-3915
Mailing Address - Fax:
Practice Address - Street 1:2024 CATON WAY SW STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8201
Practice Address - Country:US
Practice Address - Phone:360-209-3143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61212049175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath