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General NPI Number Information
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NPI Number | 1801050786
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Entity Type | Organization
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Legal Business Name | EMERALD CENTER FOR INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 9730 3RD AVE NE SUITE 202
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City | SEATTLE
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State | WA
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Zip | 98115-2023
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Country | US
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Telephone | 206-525-5576
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Fax | 206-525-5776
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Provider Business Mailing Address
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Address Line | PO BOX 78193
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City | SEATTLE
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State | WA
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Zip | 98178-0193
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Country | US
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Telephone | 206-772-5315
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Fax | 206-774-8751
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | MOIRA P FITZPATRICK
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Credential | PHD, ND
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Telephone | 206-525-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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