NPIMap

Organization Active NPI

Absolute Wellness Clinic, P.S.

  • Non-Pharmacy Dispensing Site
  • Issaquah, WA
National Provider Identifier
1841646296
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
NT60060007 Issued in WA
Legal business name
ABSOLUTE WELLNESS CLINIC, P.S.
Practice address
465 Rainier Blvd N
Suite a
Issaquah, WA 98027-2826
Phone
(425) 392-5321
Fax
(888) 431-8819
NPI assigned
May 4, 2016
Last updated
May 4, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ABSOLUTE WELLNESS CLINIC, P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Lindsay A. Wais, NDNPI 1649410333
Title
Owner
Phone
(425) 392-5321

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 NT60060007 WA Primary

Addresses

Primary practice location

465 Rainier Blvd N
Suite a
Issaquah, WA 98027-2826

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 943-4180

National Provider Directory

National Provider Directory
Part of
Absolute Wellness Clinic PS

Locations

465 Rainier Blvd N
Ste A
Issaquah, WA 98027
Phone (425) 392-5321

Practitioners & affiliated clinicians

Practitioners 2

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": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1841646296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "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": "465 RAINIER BLVD N",
            "address_2": "SUITE A",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272826",
            "telephone_number": "425-392-5321",
            "fax_number": "888-431-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUTE WELLNESS CLINIC, P.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABSOLUTE WELLNESS CLINIC, P.S.",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "WAIS",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-392-5321",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WA",
            "license": "NT60060007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.