Provider Demographics
NPI:1447141494
Name:LUPINE PEAK WELLNESS, LLC
Entity type:Organization
Organization Name:LUPINE PEAK WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:425-490-7472
Mailing Address - Street 1:11601 HARBOUR POINTE BLVD #17 STE 103
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-5262
Mailing Address - Country:US
Mailing Address - Phone:425-490-7472
Mailing Address - Fax:
Practice Address - Street 1:4803 84TH ST SW
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3023
Practice Address - Country:US
Practice Address - Phone:425-490-7472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty