1174895270 NPI number — TRANSFORMATIVE HEALTH STRATEGIES, PLLC

Table of content: (NPI 1174895270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174895270 NPI number — TRANSFORMATIVE HEALTH STRATEGIES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSFORMATIVE HEALTH STRATEGIES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174895270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3876 BRIDGE WAY N STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98103-7951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-355-0177
Provider Business Mailing Address Fax Number:
206-826-1393

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7020 7TH AVE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98117-4949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-355-0177
Provider Business Practice Location Address Fax Number:
206-826-1393
Provider Enumeration Date:
02/04/2012

Additional Information

Authorized Official

Authorized Official Last Name:
NEWTON
Authorized Official First Name:
COURTENAY
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
MEMBER/NATUROPATHIC PHYSICIAN
Authorized Official Telephone Number:
206-355-0177

Provider Taxonomy Codes

  • Taxonomy code: 175F00000X , with the licence number:  NT60254852 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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