Healthcare Provider Details
I. General information
NPI: 1437078383
Provider Name (Legal Business Name): WELLNESS WORKFORCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12901 28TH PL NE STE 5
LAKE STEVENS WA
98258-9230
US
IV. Provider business mailing address
6628 77TH PL NE
MARYSVILLE WA
98270-3351
US
V. Phone/Fax
- Phone: 425-535-2905
- Fax:
- Phone: 425-535-2905
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
BRE
NICOLE
JORDON
Title or Position: OWNER
Credential: LMT
Phone: 425-535-2905