Healthcare Provider Details

I. General information

NPI: 1750408704
Provider Name (Legal Business Name): BELLTOWN SPINE AND WELLNESS CENTER, INC., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 3RD AVE
SEATTLE WA
98121-1214
US

IV. Provider business mailing address

2606 3RD AVE
SEATTLE WA
98121-1214
US

V. Phone/Fax

Practice location:
  • Phone: 206-441-7984
  • Fax: 206-728-1230
Mailing address:
  • Phone: 206-441-7984
  • Fax: 206-728-1230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3016
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2614
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1278
License Number StateWA

VIII. Authorized Official

Name: DR. SCOTT V MINDEL
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 206-441-7984