Provider Demographics
NPI:1033530415
Name:ACTUAL WELLNESS
Entity Type:Organization
Organization Name:ACTUAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CERTIFIED NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCN
Authorized Official - Phone:360-320-6772
Mailing Address - Street 1:1512 NE 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5745
Mailing Address - Country:US
Mailing Address - Phone:360-320-6772
Mailing Address - Fax:425-526-5659
Practice Address - Street 1:2411 PACIFIC AVE SE FL 1
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2048
Practice Address - Country:US
Practice Address - Phone:360-320-6772
Practice Address - Fax:425-526-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU60316605133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty