Healthcare Provider Details

I. General information

NPI: 1427591981
Provider Name (Legal Business Name): NATALIE WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23718 BOTHELL EVERETT HWY
BOTHELL WA
98021-9363
US

IV. Provider business mailing address

23718 BOTHELL EVERETT HWY
BOTHELL WA
98021-9363
US

V. Phone/Fax

Practice location:
  • Phone: 425-485-4323
  • Fax:
Mailing address:
  • Phone: 425-485-4323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number92488
License Number StateWA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: