Provider Demographics
NPI:1275687840
Name:NURTURING EXPRESSIONS, LLC
Entity Type:Organization
Organization Name:NURTURING EXPRESSIONS, LLC
Other - Org Name:OPTIMUM WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:206-763-2733
Mailing Address - Street 1:4746 44TH AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4489
Mailing Address - Country:US
Mailing Address - Phone:206-763-2733
Mailing Address - Fax:206-763-2122
Practice Address - Street 1:4746 44TH AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4489
Practice Address - Country:US
Practice Address - Phone:206-763-2733
Practice Address - Fax:206-763-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WL0100X, 174N00000X, 175F00000X
WA602428382332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9055575Medicaid
WA9055575Medicaid