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General NPI Number Information
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NPI Number | 1326458910
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF COMPLEMENTARY MEDICINE LLC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 1600 E JEFFERSON STREET SUITE 603
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City | SEATTLE
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State | WA
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Zip | 98122
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Country | US
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Telephone | 206-726-0034
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Fax | 206-726-9434
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Provider Business Mailing Address
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Address Line | 1600 E JEFFERSON STREET SUITE 603
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City | SEATTLE
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State | WA
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Zip | 98122
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Country | US
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Telephone | 206-726-0034
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Fax | 206-726-9434
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MS. KIM MICHELE CELMER
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Credential | ND
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Telephone | 206-726-0034
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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 | WA00000832
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License Number State | WA
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