Provider Demographics
NPI:1538624168
Name:ORCA WELLNESS
Entity type:Organization
Organization Name:ORCA WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP
Authorized Official - Phone:206-225-4853
Mailing Address - Street 1:511 BOREN AVE N STE 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-5505
Mailing Address - Country:US
Mailing Address - Phone:206-324-5433
Mailing Address - Fax:206-324-1646
Practice Address - Street 1:511 BOREN AVE N STE 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5505
Practice Address - Country:US
Practice Address - Phone:206-324-5433
Practice Address - Fax:206-324-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty