Provider Demographics
NPI:1316363997
Name:WEST SEATTLE WELLNESS, LLC
Entity Type:Organization
Organization Name:WEST SEATTLE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BIELLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-453-5397
Mailing Address - Street 1:2600 SW BARTON ST STE A24
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3993
Mailing Address - Country:US
Mailing Address - Phone:206-453-5397
Mailing Address - Fax:206-453-5630
Practice Address - Street 1:2600 SW BARTON ST STE A24
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3993
Practice Address - Country:US
Practice Address - Phone:206-453-5397
Practice Address - Fax:206-453-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty