Provider Demographics
NPI:1104967827
Name:SOUND HEALTH AND WELLNESS CENTER INC.
Entity type:Organization
Organization Name:SOUND HEALTH AND WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHLIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-779-5461
Mailing Address - Street 1:19735 10TH AVE NE
Mailing Address - Street 2:SUITE S102
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7693
Mailing Address - Country:US
Mailing Address - Phone:360-779-5461
Mailing Address - Fax:360-779-6182
Practice Address - Street 1:19735 10TH AVE NE
Practice Address - Street 2:SUITE S102
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7693
Practice Address - Country:US
Practice Address - Phone:360-779-5461
Practice Address - Fax:360-779-6182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1102250Medicaid
WAAB01574Medicare ID - Type Unspecified
WAB09806Medicare UPIN
WA1104967827Medicare PIN