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General NPI Number Information
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NPI Number | 1326316928
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Entity Type | Organization
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Legal Business Name | HEALING PONDS NORTHWEST LLC
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 01/25/2019
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Provider Practice Location Address
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Address Line | 2324 CALIFORNIA AVE SW
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City | SEATTLE
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State | WA
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Zip | 98116-2403
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Country | US
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Telephone | 206-682-0676
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Fax | 206-623-0397
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Provider Business Mailing Address
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Address Line | 2324 CALIFORNIA AVE SW
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City | SEATTLE
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State | WA
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Zip | 98116-2403
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Country | US
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Telephone | 206-682-0676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA XENIA POND
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Credential | EAMP
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Telephone | 206-795-6462
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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 | AC60091482
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH60076566
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License Number State | WA
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