Healthcare Provider Details

I. General information

NPI: 1043914815
Provider Name (Legal Business Name): ROOTS & WINGS MENTAL HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 192ND PL SE
BOTHELL WA
98012-6974
US

IV. Provider business mailing address

2510 192ND PL SE
BOTHELL WA
98012-6974
US

V. Phone/Fax

Practice location:
  • Phone: 425-273-7064
  • Fax:
Mailing address:
  • Phone: 425-273-7064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. ARVINDER KAUL
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 425-273-7064