Provider Demographics
NPI:1194022426
Name:SEWARD PARK THERAPEUTICS
Entity Type:Organization
Organization Name:SEWARD PARK THERAPEUTICS
Other - Org Name:SEWARD PARK NATURAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKWOOD-WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-772-0898
Mailing Address - Street 1:8435 S 114TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3321
Mailing Address - Country:US
Mailing Address - Phone:206-772-0898
Mailing Address - Fax:206-508-4136
Practice Address - Street 1:8435 S 114TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-3321
Practice Address - Country:US
Practice Address - Phone:206-772-0898
Practice Address - Fax:206-508-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALAC488171100000X
WAMA00023864225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty