Healthcare Provider Details

I. General information

NPI: 1235927369
Provider Name (Legal Business Name): GOLDEN HOLISTIC WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13620 NE 20TH ST STE G
BELLEVUE WA
98005-4901
US

IV. Provider business mailing address

1400 LAKE WASHINGTON BLVD N APT A109
RENTON WA
98056-2599
US

V. Phone/Fax

Practice location:
  • Phone: 425-550-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: HIND GOLDEN
Title or Position: MANAGER
Credential: NUTRITIONIST
Phone: 206-501-0670