Provider Demographics
NPI:1407131931
Name:CLEARWATER HEALTHCARE
Entity Type:Organization
Organization Name:CLEARWATER HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:406-551-1441
Mailing Address - Street 1:670 S FERGUSON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6493
Mailing Address - Country:US
Mailing Address - Phone:406-551-1441
Mailing Address - Fax:406-551-1442
Practice Address - Street 1:670 S FERGUSON AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6493
Practice Address - Country:US
Practice Address - Phone:406-551-1441
Practice Address - Fax:406-551-1442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT125175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty