Provider Demographics
NPI:1043549025
Name:WELLNESS ACUPUNCTURE & NATURAL MEDICINE INC.
Entity Type:Organization
Organization Name:WELLNESS ACUPUNCTURE & NATURAL MEDICINE INC.
Other - Org Name:WELLNESS ACUPUNCTURE & NATURAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:DRAKE
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:425-818-8248
Mailing Address - Street 1:1515 116TH AVE NE STE 109
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3827
Mailing Address - Country:US
Mailing Address - Phone:425-818-8248
Mailing Address - Fax:425-818-1418
Practice Address - Street 1:1515 116TH AVE NE STE 109
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3827
Practice Address - Country:US
Practice Address - Phone:425-818-8248
Practice Address - Fax:425-818-1418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty