Provider Demographics
NPI:1073746921
Name:INTEGRAL ELEMENT LLC
Entity Type:Organization
Organization Name:INTEGRAL ELEMENT LLC
Other - Org Name:INTEGRAL ELEMENT NATURAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:HURNE
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-770-4606
Mailing Address - Street 1:2840 SW RAYMOND ST
Mailing Address - Street 2:#204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-2992
Mailing Address - Country:US
Mailing Address - Phone:425-770-4606
Mailing Address - Fax:
Practice Address - Street 1:328 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1812
Practice Address - Country:US
Practice Address - Phone:360-794-4500
Practice Address - Fax:360-863-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60063068175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty