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General NPI Number Information
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NPI Number | 1033850474
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Entity Type | Organization
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Legal Business Name | SUNDEW INTEGRATED RECOVERY PLLC
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Dates
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Enumeration Date | 04/07/2022
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 5005 200TH ST SW STE B
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City | LYNNWOOD
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State | WA
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Zip | 98036-6679
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Country | US
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Telephone | 425-224-7188
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Fax | 949-250-6911
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Provider Business Mailing Address
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Address Line | 5005 200TH ST SW STE B
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City | LYNNWOOD
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State | WA
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Zip | 98036-6679
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Country | US
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Telephone | 425-224-7188
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Fax | 949-250-6911
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ANDREW DZIKOWSKI
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Credential | ND, L.AC, ARNP
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Telephone | 201-600-6817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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