| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760022156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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