Provider Demographics
NPI:1447676804
Name:CEDAR NATURAL MEDICINE PLL
Entity type:Organization
Organization Name:CEDAR NATURAL MEDICINE PLL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:206-735-0030
Mailing Address - Street 1:11821 NE 128TH ST STE H
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7210
Mailing Address - Country:US
Mailing Address - Phone:206-618-6549
Mailing Address - Fax:425-968-6367
Practice Address - Street 1:11821 NE 128TH ST STE H
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7210
Practice Address - Country:US
Practice Address - Phone:206-618-6549
Practice Address - Fax:425-968-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60140585171100000X
WANT60187892175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty