Provider Demographics
NPI:1871876706
Name:ALTMAN, LELA D (ND, LAC)
Entity type:Individual
Prefix:
First Name:LELA
Middle Name:D
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84909
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6209
Mailing Address - Country:US
Mailing Address - Phone:206-834-4100
Mailing Address - Fax:206-834-4131
Practice Address - Street 1:3670 STONE WAY N.
Practice Address - Street 2:STE N271
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8004
Practice Address - Country:US
Practice Address - Phone:206-834-4100
Practice Address - Fax:206-834-4131
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60263141171100000X
WA175F00000X
WANT60246712175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist