Healthcare Provider Details

I. General information

NPI: 1760088959
Provider Name (Legal Business Name): ISSAQUAH HOLISTIC HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 SE 272ND ST STE 105
KENT WA
98042-9918
US

IV. Provider business mailing address

15215 SE 272ND ST STE 105
KENT WA
98042-9918
US

V. Phone/Fax

Practice location:
  • Phone: 425-395-7542
  • Fax: 425-657-0934
Mailing address:
  • Phone: 425-395-7542
  • Fax: 425-657-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ALEXANDRIA EASTER
Title or Position: OWNER
Credential: ND
Phone: 206-859-1378