NPIMap

Organization Active NPI

Purity Integrative Health & Wellness Center, PLLC

  • Non-Pharmacy Dispensing Site
  • Mill Creek, WA
National Provider Identifier
1912274408
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
NT 60255395 Issued in WA
Legal business name
PURITY INTEGRATIVE HEALTH & WELLNESS CENTER, PLLC
Practice address
15118 Main St
Suite 500
Mill Creek, WA 98012-1653
Phone
(425) 337-7029
NPI assigned
Nov 28, 2011
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
PURITY INTEGRATIVE HEALTH & WELLNESS CENTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Chelsea R. Gordon, ND
Title
Owner
Phone
(425) 337-7029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NT 60255395 WA Primary

Addresses

Primary practice location

15118 Main St
Suite 500
Mill Creek, WA 98012-1653

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Purity Integrative Health Wellness Center PLLC3 organizations share this tax ID, including this one
Part of
Purity Integrative Health Wellness Center PLLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11314 4th Ave W
Ste 107
Everett, WA 98204

15118 Main St
Ste 500
Mill Creek, WA 98012
Phone (206) 890-4882

3922 148th St SE
Ste 203
Mill Creek, WA 98012
Phone (425) 225-5310

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1912274408",
    "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": "15118 MAIN ST",
            "address_2": "SUITE 500",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121653",
            "telephone_number": "425-337-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURITY INTEGRATIVE HEALTH & WELLNESS CENTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PURITY INTEGRATIVE HEALTH & WELLNESS CENTER, PLLC",
        "enumeration_date": "2011-11-28",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-337-7029",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WA",
            "license": "NT 60255395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.