Provider Demographics
NPI:1063246668
Name:H&G WELLNESS PS
Entity type:Organization
Organization Name:H&G WELLNESS PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVGORODNIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-327-7025
Mailing Address - Street 1:14700 NE 8TH ST #115
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:425-644-8386
Mailing Address - Fax:425-644-2560
Practice Address - Street 1:14700 NE 8TH ST #115
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007
Practice Address - Country:US
Practice Address - Phone:425-644-8386
Practice Address - Fax:425-644-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty