MEDICARE: DR. AMY SUZANNE WELLS ND, LMT

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	225700000X	Massage Therapist	MA00009672	WA
2	175F00000X	Naturopath	NT60059892	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0110798	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1881860799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY SUZANNE WELLS ND, LMT

Provider Business Mailing Address
First Line	:	5470 SHILSHOLE AVE NW STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4040
Country	:	US
Telephone Number	:	206-632-2154
Fax Number	:	866-533-0039

Provider Business Practice Location Address
First Line	:	5470 SHILSHOLE AVE NW STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4040
Country	:	US
Telephone Number	:	206-632-2154
Fax Number	:	866-533-0039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	01/15/2025

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