Extraordinary Wellness, PLLC

Primary specialty

NaturopathTaxonomy code 175F00000X

Legal business name

EXTRAORDINARY WELLNESS, PLLC

Practice address

21410 1St Ave W Unit B
Bothell, WA 98021-7514

Phone

(928) 303-1593

NPI assigned

Oct 1, 2021

Last updated

Oct 1, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marissa S Boyd, NDNPI 1619511466

Title

Owner, Managing Member

Phone

(928) 303-1593

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marissa Sue Boyd, ND

  • Naturopath
  • Bothell, WA
  • NPI 1619511466
  NPD Authorized official

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1063184679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21410 1ST AVE W UNIT B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217514",
            "telephone_number": "928-303-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21410 1ST AVE W UNIT B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217514",
            "telephone_number": "928-303-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRAORDINARY WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER, MANAGING MEMBER",
        "authorized_official_telephone_number": "928-303-1593",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Naturopath in Bothell, WA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.