Provider Demographics
NPI:1043597578
Name:ALPINE INTEGRATED MEDICINE LLC
Entity Type:Organization
Organization Name:ALPINE INTEGRATED MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIE-RENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-949-5961
Mailing Address - Street 1:22635 NE MARKETPLACE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5885
Mailing Address - Country:US
Mailing Address - Phone:425-949-5961
Mailing Address - Fax:425-949-5962
Practice Address - Street 1:22635 NE MARKETPLACE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5885
Practice Address - Country:US
Practice Address - Phone:425-949-5961
Practice Address - Fax:425-949-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-11
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00003009171100000X
WAMA000232120174400000X
WANT00001446175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty