Healthcare Provider Details

I. General information

NPI: 1629343207
Provider Name (Legal Business Name): KIRKLAND FAMILY HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 7TH AVE
KIRKLAND WA
98033-5665
US

IV. Provider business mailing address

634 7TH AVE
KIRKLAND WA
98033-5665
US

V. Phone/Fax

Practice location:
  • Phone: 425-827-0334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID BOURREE
Title or Position: MEMBER
Credential: DC
Phone: 425-827-0334