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General NPI Number Information
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NPI Number | 1700124344
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Entity Type | Organization
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Legal Business Name | SHORELINE NATURAL MEDICINE CLINIC, INC
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 646 NW RICHMOND BEACH RD
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City | SHORELINE
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State | WA
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Zip | 98177-3122
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Country | US
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Telephone | 206-542-8687
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1418
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City | EDMONDS
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State | WA
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Zip | 98020-1418
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Country | US
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Telephone | 206-542-8687
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Fax | 206-542-8336
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANCIS A. PINAULT
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Credential | ND
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Telephone | 206-542-8687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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