Provider Demographics
NPI:1093081424
Name:HEALTH BY DESIGN WELLNESS CENTER
Entity Type:Organization
Organization Name:HEALTH BY DESIGN WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BASILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-550-8545
Mailing Address - Street 1:5610 KITSAP WAY STE 260
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-2266
Mailing Address - Country:US
Mailing Address - Phone:360-478-2100
Mailing Address - Fax:
Practice Address - Street 1:5610 KITSAP WAY STE 260
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-2266
Practice Address - Country:US
Practice Address - Phone:360-478-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG217000653Medicare PIN