Healthcare Provider Details
I. General information
NPI: 1396077004
Provider Name (Legal Business Name): CONNECTED WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12501 BEL RED RD 108
BELLEVUE WA
98005-2509
US
IV. Provider business mailing address
PO BOX 97
BELLEVUE WA
98009-0097
US
V. Phone/Fax
- Phone: 425-450-0100
- Fax: 425-450-0200
- Phone: 425-450-0100
- Fax: 425-450-0200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | NT00001073 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
MICHELLE
MARY
TURCOTTE
Title or Position: MEDICAL DIRECTOR
Credential: ND
Phone: 425-450-0100