Healthcare Provider Details

I. General information

NPI: 1871356998
Provider Name (Legal Business Name): NORTHGATE ACCIDENT & INJURY PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 02/01/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10564 5TH AVE. NE SUITE 402
SEATTLE WA
98125
US

IV. Provider business mailing address

10564 5TH AVE. NE SUITE 402
SEATTLE WA
98125
US

V. Phone/Fax

Practice location:
  • Phone: 206-420-3531
  • Fax: 206-588-2603
Mailing address:
  • Phone: 206-420-3531
  • Fax: 206-588-2603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. TREVOR LOWELL NABHOLZ
Title or Position: OWNER
Credential: D.C.
Phone: 206-420-3531