Healthcare Provider Details

I. General information

NPI: 1588593289
Provider Name (Legal Business Name): BRIDGET WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 GONDOLA CT
SANDPOINT ID
83864-2147
US

IV. Provider business mailing address

1624 GONDOLA CT
SANDPOINT ID
83864-2147
US

V. Phone/Fax

Practice location:
  • Phone: 425-829-6614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: