NPIMap

Organization Active NPI

Wholehearted Functional Medicine

  • Health Service Clinic/Center
  • Port Angeles, WA
National Provider Identifier
1073062972
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
AP300006177 Issued in WA
Legal business name
WHOLEHEARTED FUNCTIONAL MEDICINE
Practice address
430 E Lauridsen Blvd
212
Port Angeles, WA 98362-7978
Phone
(360) 457-5139
NPI assigned
Oct 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Rebecca Zambito, ARNPNPI 1568494334
Title
Owner
Phone
(360) 457-5139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X AP300006177 WA Primary

Addresses

Primary practice location

430 E Lauridsen Blvd
212
Port Angeles, WA 98362-7978

Mailing address

430 E Lauridsen Blvd
212
Port Angeles, WA 98362-7978
Phone (360) 457-5139

National Provider Directory

National Provider Directory

Locations

430 E Lauridsen Blvd
Ste 212
Port Angeles, WA 98362
Phone (360) 457-5139

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1073062972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD",
            "address_2": "212",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E LAURIDSEN BLVD",
            "address_2": "212",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983627978",
            "telephone_number": "360-457-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLEHEARTED FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "ZAMBITO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-457-5139",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "AP300006177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.