Healthcare Provider Details

I. General information

NPI: 1548535255
Provider Name (Legal Business Name): PRAXIS-HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 RESERVATION RD SE
OLYMPIA WA
98513-9415
US

IV. Provider business mailing address

5408 96TH AVENUE CT W
UNIVERSITY PLACE WA
98467-1314
US

V. Phone/Fax

Practice location:
  • Phone: 253-565-0130
  • Fax: 253-565-0130
Mailing address:
  • Phone: 253-961-7754
  • Fax: 253-565-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAP30007487
License Number StateWA

VIII. Authorized Official

Name: MARCHELL RENE SPIELMANN
Title or Position: OWNER
Credential: ARNP
Phone: 253-565-0130