Healthcare Provider Details

I. General information

NPI: 1346027562
Provider Name (Legal Business Name): ANXIENT EMBERS HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 NW 54TH ST STE 234
SEATTLE WA
98107-3570
US

IV. Provider business mailing address

1417 NW 54TH ST STE 234
SEATTLE WA
98107-3570
US

V. Phone/Fax

Practice location:
  • Phone: 206-593-3609
  • Fax: 206-326-1890
Mailing address:
  • Phone: 206-593-3609
  • Fax: 206-326-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNETTE SCHNEIDER
Title or Position: OWNER
Credential:
Phone: 206-593-3609