NPIMap

Organization Active NPI

Source Northwest Integrative Medicine

Doing business as Stanwood Integrative Medicine

  • Naturopath
  • Stanwood, WA
National Provider Identifier
1063971703
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
Legal business name
SOURCE NORTHWEST INTEGRATIVE MEDICINE
Doing business as
Stanwood Integrative Medicine
Practice address
7206 267TH St NW Ste 102
Stanwood, WA 98292-6269
Phone
(360) 629-2222
Fax
(360) 629-7074
NPI assigned
Mar 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Dr. Carrie L Hardy, NDNPI 1285185744
Title
Physician
Phone
(360) 629-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 175F00000X Primary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

7206 267TH St NW Ste 102
Stanwood, WA 98292-6269

Mailing address

7206 267TH St NW Ste 102
Stanwood, WA 98292-6269
Phone (360) 629-2222

Other names 1

  • Stanwood Integrative Medicine Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2145919Stanwood Integrative Medicine7206 267TH St NW Ste 102, Stanwood, WA 98292Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

7206 267th St NW
Ste 102
Stanwood, WA 98292
Phone (360) 421-9332

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1063971703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 267TH ST NW STE 102",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926269",
            "telephone_number": "360-629-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7206 267TH ST NW STE 102",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926269",
            "telephone_number": "360-629-2222",
            "fax_number": "360-629-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE NORTHWEST INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "360-629-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanwood Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.