Provider Demographics
NPI:1881237584
Name:PUGET SOUND NATURAL MEDICINE, LLC
Entity type:Organization
Organization Name:PUGET SOUND NATURAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:W
Authorized Official - Last Name:GILBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ND
Authorized Official - Phone:253-579-3958
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0100
Mailing Address - Country:US
Mailing Address - Phone:253-579-3958
Mailing Address - Fax:253-845-5252
Practice Address - Street 1:1420 S MERIDIAN STE A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6914
Practice Address - Country:US
Practice Address - Phone:253-579-3958
Practice Address - Fax:253-845-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care