Healthcare Provider Details

I. General information

NPI: 1881860799
Provider Name (Legal Business Name): AMY SUZANNE WELLS ND, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5470 SHILSHOLE AVE NW STE 300
SEATTLE WA
98107-4040
US

IV. Provider business mailing address

5470 SHILSHOLE AVE NW STE 300
SEATTLE WA
98107-4040
US

V. Phone/Fax

Practice location:
  • Phone: 206-632-2154
  • Fax: 866-533-0039
Mailing address:
  • Phone: 206-632-2154
  • Fax: 866-533-0039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60059892
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00009672
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: