Organization Active NPI

Trillium Natural Medicine, LLC

  • Non-Pharmacy Dispensing Site
  • Bainbridge Island, WA
National Provider Identifier
1265824437
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
NT 00001299 Issued in WA
Legal business name
TRILLIUM NATURAL MEDICINE, LLC
Practice address
159 Wyatt Way NE
Bainbridge Island, WA 98110-1878
Phone
(206) 304-8756
NPI assigned
Feb 25, 2015
Organization subpart
Yes
Parent organization
TRILLIUM NATURAL MEDICINE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Authorized official

Name
Alexander C. Kraft, NDNPI 1982789871
Title
Owner
Phone
(206) 304-8756

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NT 00001299 WA Primary

Addresses

Primary practice location

159 Wyatt Way NE
Bainbridge Island, WA 98110-1878

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 943-4180

National Provider Directory

National Provider Directory
Part of
Trillium Natural Medicine LLC

Practitioners & affiliated clinicians

Practitioners 1

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": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1265824437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-943-4180",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 WYATT WAY NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101878",
            "telephone_number": "206-304-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM NATURAL MEDICINE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRILLIUM NATURAL MEDICINE, LLC",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-304-8756",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WA",
            "license": "NT 00001299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.