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General NPI Number Information
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NPI Number | 1396077004
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Entity Type | Organization
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Legal Business Name | CONNECTED WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12501 BEL RED RD 108
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City | BELLEVUE
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State | WA
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Zip | 98005-2509
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Country | US
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Telephone | 425-450-0100
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Fax | 425-450-0200
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Provider Business Mailing Address
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Address Line | PO BOX 97
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City | BELLEVUE
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State | WA
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Zip | 98009-0097
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Country | US
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Telephone | 425-450-0100
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Fax | 425-450-0200
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHELLE MARY TURCOTTE
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Credential | ND
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Telephone | 425-450-0100
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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 | NT00001073
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License Number State | WA
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