Provider Demographics
NPI:1306240874
Name:SPECIALTY NATURAL MEDICINE, INC PC
Entity type:Organization
Organization Name:SPECIALTY NATURAL MEDICINE, INC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ARMIJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-423-0878
Mailing Address - Street 1:8423 MUKILTEO SPEEDWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-3237
Mailing Address - Country:US
Mailing Address - Phone:425-423-0878
Mailing Address - Fax:425-669-9538
Practice Address - Street 1:8423 MUKILTEO SPEEDWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3237
Practice Address - Country:US
Practice Address - Phone:425-423-0878
Practice Address - Fax:425-669-9538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 00001272175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty