Basic Information
| Provider Information | |||||||||
| NPI: | 1861823932 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATURAL HEALTHCARE NORTHWEST, INC., P.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2980 N BEVERLY GLEN CIR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900771726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109434180 | ||||||||
| FaxNumber: | 8884318819 | ||||||||
| Practice Location | |||||||||
| Address1: | 509 OLIVE WAY | ||||||||
| Address2: | SUITE 1315 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063829977 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2013 | ||||||||
| LastUpdateDate: | 10/05/2015 | ||||||||
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| AuthorizedOfficialLastName: | BUXTON | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | P. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2063829977 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NATURAL HEALTHCARE NORTHWEST, INC., P.S. | ||||||||
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| AuthorizedOfficialCredential: | N.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | NT 00000913 | WA | Y | Suppliers | Non-Pharmacy Dispensing Site |
No ID Information.