Healthcare Provider Details

I. General information

NPI: 1952176620
Provider Name (Legal Business Name): NAMAYASTE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 LAKE WASHINGTON BLVD N UNIT 3
RENTON WA
98056-0703
US

IV. Provider business mailing address

1322 LAKE WASHINGTON BLVD N UNIT 3
RENTON WA
98056-0703
US

V. Phone/Fax

Practice location:
  • Phone: 425-271-0200
  • Fax:
Mailing address:
  • Phone: 310-770-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: IKEMEFUNA UDEZE
Title or Position: OWNER
Credential:
Phone: 310-770-5322