Provider Demographics
NPI:1700124344
Name:SHORELINE NATURAL MEDICINE CLINIC, INC
Entity Type:Organization
Organization Name:SHORELINE NATURAL MEDICINE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINAULT
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-542-8687
Mailing Address - Street 1:PO BOX 1418
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-1418
Mailing Address - Country:US
Mailing Address - Phone:206-542-8687
Mailing Address - Fax:206-542-8336
Practice Address - Street 1:646 NW RICHMOND BEACH RD
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3122
Practice Address - Country:US
Practice Address - Phone:206-542-8687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHORELINE NATURAL MEDICINE CLINIC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-16
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site