Provider Demographics
NPI:1477147593
Name:HEALTH AND WELLNESS OF KIRKLAND LLC
Entity Type:Organization
Organization Name:HEALTH AND WELLNESS OF KIRKLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-697-2122
Mailing Address - Street 1:5045 NE WATERVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-4508
Mailing Address - Country:US
Mailing Address - Phone:360-697-2122
Mailing Address - Fax:
Practice Address - Street 1:355 KIRKLAND AVE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6221
Practice Address - Country:US
Practice Address - Phone:425-367-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty