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General NPI Number Information
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NPI Number | 1710100268
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Entity Type | Organization
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Legal Business Name | AYU NATURAL MEDICINE CLINIC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 819 NE 65TH ST
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City | SEATTLE
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State | WA
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Zip | 98115-5539
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Country | US
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Telephone | 206-729-9999
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Fax | 206-729-0164
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Provider Business Mailing Address
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Address Line | 819 NE 65TH ST
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City | SEATTLE
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State | WA
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Zip | 98115-5539
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Country | US
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Telephone | 206-729-9999
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Fax | 206-729-0164
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS PSALM RENEE POLLOCK
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Credential |
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Telephone | 206-729-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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