Provider Demographics
NPI:1083328140
Name:SIMPLE INDULGENCE WELLNESS
Entity Type:Organization
Organization Name:SIMPLE INDULGENCE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLET
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMITSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:509-850-9710
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE PASS
Mailing Address - State:WA
Mailing Address - Zip Code:98068-0213
Mailing Address - Country:US
Mailing Address - Phone:509-850-9710
Mailing Address - Fax:
Practice Address - Street 1:101 W MONTANA AVE
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:WA
Practice Address - Zip Code:98941-5835
Practice Address - Country:US
Practice Address - Phone:509-850-9710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service