Provider Demographics
NPI:1235509126
Name:SERENE NATURAL HEALTH, LLC
Entity Type:Organization
Organization Name:SERENE NATURAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:425-689-7007
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1728
Mailing Address - Country:US
Mailing Address - Phone:310-943-4180
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:7500 212TH ST SW STE 211
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7617
Practice Address - Country:US
Practice Address - Phone:425-689-7007
Practice Address - Fax:425-777-2105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERENE NATURAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001131332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site