Provider Demographics
NPI:1194108894
Name:SYNERGY WELLNESS CENTER
Entity type:Organization
Organization Name:SYNERGY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFAY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-828-4000
Mailing Address - Street 1:515 KIRKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6219
Mailing Address - Country:US
Mailing Address - Phone:425-828-4000
Mailing Address - Fax:
Practice Address - Street 1:515 KIRKLAND WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6219
Practice Address - Country:US
Practice Address - Phone:425-828-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 00002626171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty