Healthcare Provider Details

I. General information

NPI: 1962319210
Provider Name (Legal Business Name): THE AWAKEN CENTER OF INTEGRATIVE MEDICINE NFP FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21827 76TH AVE W STE 201
EDMONDS WA
98026-7981
US

IV. Provider business mailing address

12013 NE 138TH PL
KIRKLAND WA
98034-2119
US

V. Phone/Fax

Practice location:
  • Phone: 206-803-1045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CHRISTOPHER WAKELY
Title or Position: EXECUTIVE DIRECTOR
Credential: ND
Phone: 425-443-8941