Provider Demographics
NPI:1609248731
Name:HEALTHY INFUSION AT AMY'S
Entity Type:Organization
Organization Name:HEALTHY INFUSION AT AMY'S
Other - Org Name:NATUROPATHIC INFUSION AT DR. AMY'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOR
Authorized Official - Suffix:
Authorized Official - Credentials:ND, EAMP
Authorized Official - Phone:425-367-9001
Mailing Address - Street 1:3503 188TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3503 188TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4707
Practice Address - Country:US
Practice Address - Phone:425-367-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60454018171100000X
WANT60452752175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty