Provider Demographics
NPI:1598548877
Name:FUNCTIONAL HEALTH CONSULTING, LLC
Entity Type:Organization
Organization Name:FUNCTIONAL HEALTH CONSULTING, LLC
Other - Org Name:VIDA INTEGRATED HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TROXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-355-5222
Mailing Address - Street 1:15 SW EVERETT MALL WAY STE G
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-2715
Mailing Address - Country:US
Mailing Address - Phone:425-355-5222
Mailing Address - Fax:425-355-5231
Practice Address - Street 1:2715 SUNSET LN NE
Practice Address - Street 2:SUITE 106
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056
Practice Address - Country:US
Practice Address - Phone:206-726-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FUNCTIONAL HEALTH CONSULTING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-18
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty