Provider Demographics
NPI:1598236572
Name:MODULLA HEALTH LLC
Entity Type:Organization
Organization Name:MODULLA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARJOMAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CN
Authorized Official - Phone:425-332-4884
Mailing Address - Street 1:14150 NE 20TH ST STE F1-182
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3700
Mailing Address - Country:US
Mailing Address - Phone:425-332-4884
Mailing Address - Fax:425-382-5121
Practice Address - Street 1:14150 NE 20TH ST STE F1-182
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3700
Practice Address - Country:US
Practice Address - Phone:425-332-4884
Practice Address - Fax:425-382-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty