MEDICARE: AMERICAN HEALTH W LLC

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	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1477261030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HEALTH W LLC

Provider Business Mailing Address
First Line	:	2200 LIND AVE SW
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-3330
Country	:	US
Telephone Number	:	954-919-5005
Fax Number	:	800-400-6972

Provider Business Practice Location Address
First Line	:	2200 LIND AVE SW
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-3330
Country	:	US
Telephone Number	:	954-919-5005
Fax Number	:	800-400-6972

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRIS MARTIN
Credential	:
Telephone Number	:	919-954-5005

Provider Enumeration Date	:	11/11/2022
Last Update Date	:	11/11/2022

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Directions to “AMERICAN HEALTH W LLC ” Practice Location

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