Healthcare Provider Details

I. General information

NPI: 1710861414
Provider Name (Legal Business Name): OPTIMUM PEAK WELLNESS PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12270 134TH CT NE STE 160
REDMOND WA
98052-7109
US

IV. Provider business mailing address

12270 134TH CT NE STE 160
REDMOND WA
98052-7109
US

V. Phone/Fax

Practice location:
  • Phone: 425-236-5932
  • Fax:
Mailing address:
  • Phone: 425-236-5932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. FRANK F MARINKOVICH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 425-899-2525