MEDICARE: VITAL LIFE SCIENCES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath

General Provider Information

NPI Number	:	1164369559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL LIFE SCIENCES, PLLC

Provider Business Mailing Address
First Line	:	2226 EASTLAKE AVE E # 1395
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-3419
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3005 ALDERWOOD MALL PKWY
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6920
Country	:	US
Telephone Number	:	205-765-8523
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LOIS HERNANDEZ
Credential	:	ND
Telephone Number	:	205-765-8523

Provider Enumeration Date	:	05/02/2026
Last Update Date	:	05/02/2026

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