Healthcare Provider Details

I. General information

NPI: 1396510871
Provider Name (Legal Business Name): FIGHT FOR W, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11226 NE 15TH ST STE 6
BELLEVUE WA
98004-3719
US

IV. Provider business mailing address

18501 SE NEWPORT WAY UNIT L350
ISSAQUAH WA
98027-9037
US

V. Phone/Fax

Practice location:
  • Phone: 206-201-4087
  • Fax: 833-914-2737
Mailing address:
  • Phone: 206-201-4087
  • Fax: 833-914-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: KESHIA A MONTE
Title or Position: OFFICE MANAGER
Credential:
Phone: 425-523-1051