Healthcare Provider Details

I. General information

NPI: 1417895814
Provider Name (Legal Business Name): WHOLISTIC HEALTH ONE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20615 BOTHELL EVERETT HWY STE A
BOTHELL WA
98012-8556
US

IV. Provider business mailing address

1328 92ND AVE NE
CLYDE HILL WA
98004-3450
US

V. Phone/Fax

Practice location:
  • Phone: 425-222-2525
  • Fax:
Mailing address:
  • Phone: 206-920-3614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JAY M BAKER
Title or Position: MEMBER
Credential:
Phone: 253-732-5487