Healthcare Provider Details

I. General information

NPI: 1245546100
Provider Name (Legal Business Name): ELIAS KASS ND, LM, CPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2010
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3316 NE 125TH ST STE 2
SEATTLE WA
98125-4565
US

IV. Provider business mailing address

3316 NE 125TH ST STE 2
SEATTLE WA
98125-4565
US

V. Phone/Fax

Practice location:
  • Phone: 206-203-2509
  • Fax: 855-897-3364
Mailing address:
  • Phone: 206-203-2509
  • Fax: 855-897-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60180931
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60169619
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: