Provider Demographics
NPI:1073839957
Name:HEALTHY WHOLE SOLUTIONS
Entity Type:Organization
Organization Name:HEALTHY WHOLE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ROSALIA
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-602-0022
Mailing Address - Street 1:1014 BAY ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5242
Mailing Address - Country:US
Mailing Address - Phone:360-602-0022
Mailing Address - Fax:360-335-6432
Practice Address - Street 1:1014 BAY ST
Practice Address - Street 2:SUITE 24
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5242
Practice Address - Country:US
Practice Address - Phone:360-602-0022
Practice Address - Fax:360-335-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18148700101YA0400X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty