| Doctor Name: | IBUKUN OMOLE |
| NPI Number: | 1508010851 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ND, LAC |
| License Number: | NT60063074 |
| Business Practice Address: | 6005 244th St Sw Ste 111 Mountlake Terrace, WA - 980435400 |
| Business Phone Number: | 4252755555 |
| Business Fax Number: | 4252755590 |
| Mailing Address: | 6005 244th St Sw, Ste 111 MOUNTLAKE TERRACE |
| State: | WA |
| Postal Code: | 980435400 |
| Phone Number: | 4252755555 |
| Fax Number: | 4252755590 |
| NPI Enumeration Date: | 11/13/2008 |
| NPI Last Update Date: | 09/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 175F00000X |
| License Number: | NT60063074 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Naturopath |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Diagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phototherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods, and herbs and nature's remedies. Excludes major surgery, therapeutic use of x ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life. |