Healthcare Provider Details

I. General information

NPI: 1811665359
Provider Name (Legal Business Name): PLANT TREKKER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22833 BOTHELL EVERETT HWY STE 206
BOTHELL WA
98021-9368
US

IV. Provider business mailing address

1306 MILL CREEK BLVD APT N201
MILL CREEK WA
98012-4023
US

V. Phone/Fax

Practice location:
  • Phone: 425-919-0856
  • Fax: 206-681-9987
Mailing address:
  • Phone: 206-790-8631
  • Fax: 206-681-9987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2128520
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer

VIII. Authorized Official

Name: DR. JAMES PENDLETON
Title or Position: OWNER
Credential: ND
Phone: 425-919-0856