Selah Wellness Clinic LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SELAH WELLNESS CLINIC LLC

Practice address

255 Highway 97 Unit 1a
Forest Lake, MN 55025-2687

Phone

(320) 372-2323

Fax

(833) 651-2526

NPI assigned

Sep 8, 2026

Organization subpart

No

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

Authorized official

Name

Naomi Koenig

Title

Ceo

Phone

(320) 372-2323

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1447160155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MAIN ST",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550724410",
            "telephone_number": "320-372-2323",
            "fax_number": "833-651-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HIGHWAY 97 UNIT 1A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252687",
            "telephone_number": "320-372-2323",
            "fax_number": "833-651-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELAH WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-372-2323"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.