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General NPI Number Information
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NPI Number | 1437403391
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Entity Type | Organization
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Legal Business Name | HCG GOLD WELLNESS CENTER
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 202 AUBURN AVE
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City | AUBURN
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State | WA
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Zip | 98002-5015
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Country | US
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Telephone | 253-939-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 21916 26TH ST E
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City | LAKE TAPPS
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State | WA
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Zip | 98391-5642
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAILEY HOLLENBECK
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Credential |
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Telephone | 253-549-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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