Watershed Wellness LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC 60065363 Issued in WA

Legal business name

WATERSHED WELLNESS LLC

Practice address

703 Lilly Rd NE
Ste 102
Olympia, WA 98506-5191

Phone

(360) 350-0773

Fax

(360) 350-0723

NPI assigned

Nov 5, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Christine Alexis Kulhawik-Hansen, EAMP, MACO.M, NTP

Title

Owner / Acupuncturist

Phone

(360) 350-0773

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1194198614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE",
            "address_2": "STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065191",
            "telephone_number": "360-350-0773",
            "fax_number": "360-350-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE",
            "address_2": "STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065191",
            "telephone_number": "360-350-0773",
            "fax_number": "360-350-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "KULHAWIK-HANSEN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER / ACUPUNCTURIST",
        "authorized_official_telephone_number": "360-350-0773",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EAMP, MACO.M, NTP"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 60065363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Stewart Wasserman, M.D.
• Valerie Waterland, MS MFT
• Lori Jeanne Waterman, PT
• Alison Waters
• Chhaya Salihah Waters
• Dara Wathanapaisal, DPT, CLT
• Ryan Wathne, LICSW
• Angus Watson, M.D.
• Joahna Watson
• Richard Allen Watts

• Acupuncturist in Olympia, WA
• Providers in Olympia, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.