Provider Demographics
NPI:1902289309
Name:DOUGLAS C. LEWIS, ND, LLC
Entity Type:Organization
Organization Name:DOUGLAS C. LEWIS, ND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-525-8078
Mailing Address - Street 1:11300 ROOSEVELT WAY NE STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6244
Mailing Address - Country:US
Mailing Address - Phone:206-525-8078
Mailing Address - Fax:206-525-1913
Practice Address - Street 1:11300 ROOSEVELT WAY NE STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6244
Practice Address - Country:US
Practice Address - Phone:206-525-8078
Practice Address - Fax:206-525-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60260599171100000X
WA0547175F00000X
WANT60216937175F00000X
WA999175F00000X
WANT60260168175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty