Northwest Functional Nutrition, Llc | |
19125 N Creek Pkwy Ste 120 Bothell WA 98011-8000 | |
(425) 588-0480 | |
Not Available |
Full Name | Northwest Functional Nutrition, Llc |
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Speciality | Clinic/center |
Location | 19125 N Creek Pkwy Ste 120, Bothell, Washington |
Authorized Official Name and Position | Nikki Gepner (OWNER) |
Authorized Official Contact | 4255880480 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Northwest Functional Nutrition, Llc Po Box 821092 Kenmore WA 98028-0999 Ph: (425) 588-0480 | Northwest Functional Nutrition, Llc 19125 N Creek Pkwy Ste 120 Bothell WA 98011-8000 Ph: (425) 588-0480 |
NPI Number | 1760022156 |
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Provider Enumeration Date | 01/14/2020 |
Last Update Date | 09/21/2021 |
Identifier | Type | State | Issuer |
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1760022156 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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