Provider Demographics
NPI:1780015537
Name:HOME WELLNESS SOLUTIONS LLC
Entity Type:Organization
Organization Name:HOME WELLNESS SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORROMEO-WESNER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-930-4538
Mailing Address - Street 1:18628 NE 139TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6586
Mailing Address - Country:US
Mailing Address - Phone:206-930-4538
Mailing Address - Fax:425-881-8725
Practice Address - Street 1:18628 NE 139TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6586
Practice Address - Country:US
Practice Address - Phone:206-930-4538
Practice Address - Fax:425-881-8725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8863104Medicare PIN