Provider Demographics
NPI:1629939111
Name:BARRETT WELLNESS LLC
Entity type:Organization
Organization Name:BARRETT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEALTH COACH/NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:SHERRY
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:CN, BHC, BMHC, IINHC
Authorized Official - Phone:918-581-3343
Mailing Address - Street 1:5530 S VANCOUVER PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-9064
Mailing Address - Country:US
Mailing Address - Phone:918-581-3343
Mailing Address - Fax:
Practice Address - Street 1:5508 S LEWIS AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7105
Practice Address - Country:US
Practice Address - Phone:918-895-1129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty