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General NPI Number Information
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NPI Number | 1639647654
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Entity Type | Organization
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Legal Business Name | LAKE UNION WELLNESS, PS
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 2033 6TH AVE STE 917
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City | SEATTLE
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State | WA
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Zip | 98121-2568
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Country | US
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Telephone | 206-749-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WESTLAKE AVE N
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City | SEATTLE
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State | WA
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Zip | 98109-5217
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Country | US
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Telephone | 206-749-5253
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TED STEFFEN
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Credential |
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Telephone | 206-749-5253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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