Healthcare Provider Details

I. General information

NPI: 1295645513
Provider Name (Legal Business Name): PERICLINE WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10005 32ND AVE NE
SEATTLE WA
98125-7801
US

IV. Provider business mailing address

10321 38TH AVE NE
SEATTLE WA
98125-7814
US

V. Phone/Fax

Practice location:
  • Phone: 206-339-7930
  • Fax: 206-752-8313
Mailing address:
  • Phone: 206-339-7930
  • Fax: 206-752-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE YOUNG
Title or Position: BUSINESS OWNER
Credential:
Phone: 206-339-7930