Healthcare Provider Details

I. General information

NPI: 1164351532
Provider Name (Legal Business Name): SAGEVITAL CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14021 NE 8TH ST
BELLEVUE WA
98007-4134
US

IV. Provider business mailing address

2808 179TH AVE NE
REDMOND WA
98052-5814
US

V. Phone/Fax

Practice location:
  • Phone: 425-298-3207
  • Fax:
Mailing address:
  • Phone: 425-298-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: HUIYI SHI
Title or Position: MANAGING MEMBER
Credential: L.AC., EAMP
Phone: 425-298-3207