Organization
FRESONKE ND, INC
Active
Other names
Island Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL K FRESONKE ND (PRESIDENT)
(206) 780-2626
Entity
Organization
Contact information
Practice address
147 MADRONE LN N, BAINBRIDGE ISLAND, WA 98110-1862
(206) 780-2626
(206) 780-0964
Mailing address
147 MADRONE LN N, BAINBRIDGE ISLAND, WA 98110-1862
(206) 780-2626
(206) 780-0964
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT00000818
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962545079
INDIVIDUAL NPI
WA
Enumeration date
10/09/2008
Last updated
10/09/2008
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