=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881860799
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY SUZANNE WELLS ND, LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2008
-----------------------------------------------------
Last Update Date | 01/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5470 SHILSHOLE AVE NW STE 300
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98107-4040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-632-2154
-----------------------------------------------------
Fax | 866-533-0039
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5470 SHILSHOLE AVE NW STE 300
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98107-4040
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-632-2154
-----------------------------------------------------
Fax | 866-533-0039
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MA00009672
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | NT60059892
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------