Provider Demographics
NPI:1346027562
Name:ANXIENT EMBERS HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:ANXIENT EMBERS HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-593-3609
Mailing Address - Street 1:1417 NW 54TH ST STE 234
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3570
Mailing Address - Country:US
Mailing Address - Phone:206-593-3609
Mailing Address - Fax:206-326-1890
Practice Address - Street 1:1417 NW 54TH ST STE 234
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3570
Practice Address - Country:US
Practice Address - Phone:206-593-3609
Practice Address - Fax:206-326-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1477126936Medicaid