Provider Demographics
NPI:1821549692
Name:TUMMY TEMPLE
Entity Type:Organization
Organization Name:TUMMY TEMPLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-527-6127
Mailing Address - Street 1:2016 NE 65TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6957
Mailing Address - Country:US
Mailing Address - Phone:206-527-6127
Mailing Address - Fax:
Practice Address - Street 1:2016 NE 65TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6957
Practice Address - Country:US
Practice Address - Phone:206-527-6127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARD1020427133V00000X
WAACUP.AC.60672521171100000X
WANT60258519175F00000X
WANT00001172175F00000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty