Wild Remembrance LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WILD REMEMBRANCE LLC

Practice address

23 Wnuk Rd
White Salmon, WA 98672-8428

Phone

(503) 705-5241

NPI assigned

Apr 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth L Hummer

Title

Owner

Phone

(503) 705-5241

Specialties & licenses 1

Addresses

Other names 1

• Wild Awaken Therapy Doing business as

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1023690765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WNUK RD",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986728428",
            "telephone_number": "503-705-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WNUK RD",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986728428",
            "telephone_number": "503-705-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD REMEMBRANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "HUMMER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-705-5241"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "liz@wildawaken.com",
            "affiliation": "N",
            "address_1": "23 Wnuk Rd",
            "city": "White Salmon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986728428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wild Awaken Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• White Salmon Acupuncture LLP
• White Salmon Family Practice Clinic
• White Salmon Valley School District
• Serena Whitridge, DSOM, LAC, MSCN
• Denison F Wiedman, LMT
• Amy Williams
• David Wiltsie
• Elizabeth Nye Winner, OTD, OTR/L
• Liette C Witherrite, MD
• Troy R Witherrite, M.D.

• Clinical Social Worker in White Salmon, WA
• Providers in White Salmon, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.