Healthcare Provider Details
I. General information
NPI: 1558686295
Provider Name (Legal Business Name): CHRISTINA GUTIERREZ ND LM INC PS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2010
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3876 BRIDGE WAY N SUITE 300
SEATTLE WA
98103-7951
US
IV. Provider business mailing address
3876 BRIDGE WAY N SUITE 300
SEATTLE WA
98103-7951
US
V. Phone/Fax
- Phone: 206-624-6627
- Fax: 206-525-5933
- Phone: 206-624-6627
- Fax: 206-525-5933
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
ELIZABETH
GUTIERREZ
Title or Position: OWNER
Credential: ND LM
Phone: 206-624-6627