Healthcare Provider Details

I. General information

NPI: 1629833900
Provider Name (Legal Business Name): PHASES CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W NORTH BEND WAY STE 200
NORTH BEND WA
98045-8169
US

IV. Provider business mailing address

201 W NORTH BEND WAY STE 200
NORTH BEND WA
98045-8169
US

V. Phone/Fax

Practice location:
  • Phone: 425-835-2726
  • Fax: 833-450-6079
Mailing address:
  • Phone: 425-835-2726
  • Fax: 206-385-3928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: VANESSA L WEILAND
Title or Position: FOUNDER
Credential: NP
Phone: 425-835-2726