Provider Demographics
NPI:1558136135
Name:ORIGINS NATURAL HEALTH, PLLC
Entity Type:Organization
Organization Name:ORIGINS NATURAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-899-8978
Mailing Address - Street 1:2528 NE 107TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6708
Mailing Address - Country:US
Mailing Address - Phone:206-899-8978
Mailing Address - Fax:
Practice Address - Street 1:1100 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5119
Practice Address - Country:US
Practice Address - Phone:206-899-8978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty