Provider Demographics
NPI:1346655123
Name:PENINSULA NATURAL HEALTH CLINIC, INC.
Entity Type:Organization
Organization Name:PENINSULA NATURAL HEALTH CLINIC, INC.
Other - Org Name:PENINSULA NATUROPATHIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATHIC DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:COLOMBINI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:253-857-5544
Mailing Address - Street 1:5603 38TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8218
Mailing Address - Country:US
Mailing Address - Phone:253-857-5544
Mailing Address - Fax:253-857-9088
Practice Address - Street 1:5603 38TH AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8218
Practice Address - Country:US
Practice Address - Phone:253-857-5544
Practice Address - Fax:253-857-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603260932171100000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty