Healthcare Provider Details
I. General information
NPI: 1588074009
Provider Name (Legal Business Name): EASTSIDE NATURAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2014
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6610 NE 181ST ST STE 2
KENMORE WA
98028-4867
US
IV. Provider business mailing address
6610 NE 181ST ST STE 2
KENMORE WA
98028-4867
US
V. Phone/Fax
- Phone: 425-814-2045
- Fax: 425-814-2783
- Phone: 425-814-2045
- Fax: 425-814-2783
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | NT60048617 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
BRIANNA
ALLAIN
PICHE
Title or Position: CO-OWNER
Credential:
Phone: 425-814-2045