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General NPI Number Information
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NPI Number | 1144351222
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Entity Type | Organization
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Legal Business Name | HEALTHWISE INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 4500 9TH AVE NE SUITE 300
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City | SEATTLE
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State | WA
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Zip | 98105-4737
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Country | US
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Telephone | 206-524-0863
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Fax | 206-524-1019
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Provider Business Mailing Address
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Address Line | 4500 9TH AVE NE SUITE 300
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City | SEATTLE
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State | WA
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Zip | 98105-4737
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Country | US
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Telephone | 206-524-0863
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Fax | 206-524-1019
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MICHELLE SIMON
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Credential | N.D. PH. D.
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Telephone | 206-524-0863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT1160
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License Number State | WA
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