Healthcare Provider Details

I. General information

NPI: 1497990444
Provider Name (Legal Business Name): 40 WINKS SLEEP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7612 NE 197TH CT
KENMORE WA
98028-2076
US

IV. Provider business mailing address

6830 NE BOTHELL WAY # C-309
KENMORE WA
98028-3546
US

V. Phone/Fax

Practice location:
  • Phone: 206-790-6129
  • Fax:
Mailing address:
  • Phone: 206-790-6129
  • Fax: 888-267-0591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
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: STEPHAN ANNEBERG
Title or Position: CEO
Credential:
Phone: 877-427-1175