Provider Demographics
NPI:1831458124
Name:NATURAL WELLNESS PLLC
Entity type:Organization
Organization Name:NATURAL WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-481-0300
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:TENINO
Mailing Address - State:WA
Mailing Address - Zip Code:98589-0014
Mailing Address - Country:US
Mailing Address - Phone:360-481-0300
Mailing Address - Fax:360-264-5999
Practice Address - Street 1:448 SUSSEX AVE E
Practice Address - Street 2:#3
Practice Address - City:TENINO
Practice Address - State:WA
Practice Address - Zip Code:98589-8703
Practice Address - Country:US
Practice Address - Phone:360-264-5999
Practice Address - Fax:369-264-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty