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General NPI Number Information
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NPI Number | 1861860090
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Entity Type | Organization
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Legal Business Name | ROOT OF MEDICINE, PLLC
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 5401 LEARY AVE NW STE 202
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City | SEATTLE
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State | WA
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Zip | 98107-4070
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Country | US
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Telephone | 206-206-2976
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Fax | 206-582-3472
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Provider Business Mailing Address
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Address Line | 5401 LEARY AVE NW STE 202
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City | SEATTLE
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State | WA
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Zip | 98107-4070
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Country | US
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Telephone | 206-206-2976
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Fax | 206-582-3472
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW JOHAN SIMON
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Credential | ND
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Telephone | 206-297-6013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT60412804
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License Number State | WA
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