Provider Demographics
NPI:1093102295
Name:SYNERGY WELLNESS CENTERS, LLC
Entity Type:Organization
Organization Name:SYNERGY WELLNESS CENTERS, LLC
Other - Org Name:NATURAL BALANCE HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-949-9303
Mailing Address - Street 1:PO BOX 14813
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98082-2813
Mailing Address - Country:US
Mailing Address - Phone:425-949-9303
Mailing Address - Fax:
Practice Address - Street 1:13416 BOTHELL EVERETT HWY
Practice Address - Street 2:STE 206
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-5311
Practice Address - Country:US
Practice Address - Phone:425-949-9303
Practice Address - Fax:425-984-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-25
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60527277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8938330OtherMEDICARE PTAN
U98254Medicare UPIN