Healthcare Provider Details

I. General information

NPI: 1598236572
Provider Name (Legal Business Name): MODULLA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 NE 20TH ST STE F1-182
BELLEVUE WA
98007-3700
US

IV. Provider business mailing address

14150 NE 20TH ST STE F1-182
BELLEVUE WA
98007-3700
US

V. Phone/Fax

Practice location:
  • Phone: 425-332-4884
  • Fax: 425-382-5121
Mailing address:
  • Phone: 425-332-4884
  • Fax: 425-382-5121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI ARJOMAND
Title or Position: DIRECTOR
Credential: PHD, CN
Phone: 425-332-4884