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General NPI Number Information
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NPI Number | 1538722947
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Entity Type | Organization
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Legal Business Name | EVO NATUROPATHIC MEDICINE AND WELLNESS PLLC
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 1231 SW 149TH ST
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City | BURIEN
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State | WA
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Zip | 98166-1750
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Country | US
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Telephone | 206-486-0967
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Fax | 206-319-4514
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Provider Business Mailing Address
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Address Line | 1231 SW 149TH ST
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City | BURIEN
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State | WA
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Zip | 98166-1750
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Country | US
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Telephone | 206-486-0967
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Fax | 206-319-4514
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANNON ESTRADA
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Credential | ND
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Telephone | 206-486-0967
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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 |
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License Number State |
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