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General NPI Number Information
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NPI Number | 1699284935
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Entity Type | Organization
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Legal Business Name | EXCEL NATUROPATHIC WELLNESS PLLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 15640 NE FOURTH PLAIN BLVD STE 120A
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City | VANCOUVER
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State | WA
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Zip | 98682
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Country | US
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Telephone | 360-719-2603
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Fax | 360-397-0447
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Provider Business Mailing Address
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Address Line | 15640 NE FOURTH PLAIN BLVD STE 120A
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City | VANCOUVER
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State | WA
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Zip | 98682-5141
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Country | US
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Telephone | 360-719-2603
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Fax | 360-397-0447
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Authorized Official
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Title or Position | OWNER
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Name | JULIA MELINDA ZAMORA
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Credential | ND
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Telephone | 360-719-2603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 604-160-120
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License Number State | WA
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