Healthcare Provider Details

I. General information

NPI: 1831425842
Provider Name (Legal Business Name): SAGE CLINTON WHEELER ND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 SE 38TH ST STE 130
BELLEVUE WA
98006-6105
US

IV. Provider business mailing address

12600 SE 38TH ST STE 130
BELLEVUE WA
98006-6105
US

V. Phone/Fax

Practice location:
  • Phone: 425-679-6056
  • Fax: 425-679-6632
Mailing address:
  • Phone: 425-679-6056
  • Fax: 425-679-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60113319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: