Healthcare Provider Details

I. General information

NPI: 1972410751
Provider Name (Legal Business Name): PATHWAY WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 MIKE ST
DICKINSON ND
58601-3085
US

IV. Provider business mailing address

1275 MIKE ST
DICKINSON ND
58601-3085
US

V. Phone/Fax

Practice location:
  • Phone: 206-970-9858
  • Fax:
Mailing address:
  • Phone: 206-970-9858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JASMINE UMUHOZA
Title or Position: CEO
Credential: CNA
Phone: 206-970-9858