Provider Demographics
NPI:1497065247
Name:HEALING WATERS,LLC
Entity Type:Organization
Organization Name:HEALING WATERS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-595-8824
Mailing Address - Street 1:164 KNECHTEL AVE. NW
Mailing Address - Street 2:
Mailing Address - City:BAIBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3537
Mailing Address - Country:US
Mailing Address - Phone:206-595-8824
Mailing Address - Fax:
Practice Address - Street 1:164 KNECHTEL AVE. NW
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-3537
Practice Address - Country:US
Practice Address - Phone:206-595-8824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00002559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty