Healthcare Provider Details

I. General information

NPI: 1871801522
Provider Name (Legal Business Name): FUNCTIONAL HEALTH CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 E MADISON ST STE 100
SEATTLE WA
98122-2965
US

IV. Provider business mailing address

2014 E MADISON ST STE 100
SEATTLE WA
98122-2965
US

V. Phone/Fax

Practice location:
  • Phone: 206-726-9595
  • Fax: 206-320-1468
Mailing address:
  • Phone: 206-726-9595
  • Fax: 206-320-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH 60126824
License Number StateWA

VIII. Authorized Official

Name: DR. KRIS AKIRA SASAKI
Title or Position: OWNER
Credential: D.C.
Phone: 206-726-9595