Provider Demographics
NPI:1114382512
Name:NOETIC HEALTH LLC
Entity Type:Organization
Organization Name:NOETIC HEALTH LLC
Other - Org Name:NOETIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWIHART
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:206-949-1875
Mailing Address - Street 1:2125 WESTERN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2125 WESTERN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2123
Practice Address - Country:US
Practice Address - Phone:206-949-1875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602903705251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health