Provider Demographics
NPI:1891576724
Name:BE WELL ENTERPRISES LLC
Entity type:Organization
Organization Name:BE WELL ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-529-4676
Mailing Address - Street 1:694 W ROSE ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2707
Mailing Address - Country:US
Mailing Address - Phone:509-529-4676
Mailing Address - Fax:509-525-1058
Practice Address - Street 1:694 W ROSE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2707
Practice Address - Country:US
Practice Address - Phone:509-529-4676
Practice Address - Fax:509-525-1058
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BE WELL ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-06
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty