Provider Demographics
NPI:1295583946
Name:RESTORATIVE HEALTH AND WELLNESS, PLLC
Entity type:Organization
Organization Name:RESTORATIVE HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:425-905-1834
Mailing Address - Street 1:PO BOX 341453
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38184-1453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 112TH AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6901
Practice Address - Country:US
Practice Address - Phone:425-905-1834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)