Healthcare Provider Details

I. General information

NPI: 1538722947
Provider Name (Legal Business Name): EVO NATUROPATHIC MEDICINE AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 10/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 194TH PL SE, UNIT D
BOTHELL WA
98012
US

IV. Provider business mailing address

PO BOX 13581
MILL CREEK WA
98082
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-0967
  • Fax: 206-319-4514
Mailing address:
  • Phone: 206-486-0967
  • Fax: 206-319-4514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SHANNON ESTRADA
Title or Position: OWNER & PROVIDER
Credential: ND
Phone: 206-486-0967