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Glacier Lake Wellness Pllc
Psychiatric/Mental Health Nurse Practitioner in Bellevue, Washington
NPI 1699310284

Glacier Lake Wellness Pllc is a Psychiatric/Mental Health Nurse Practitioner based in Chicago, WA and is specialized in Psychiatric/Mental Health. Glacier Lake Wellness Pllc practices in Bellevue, WA. The NPI Number for Glacier Lake Wellness Pllc is 1699310284 and holds a License No. (Washington).

The current practice location address for Glacier Lake Wellness Pllc is 1400 112Th Ave Se Ste 100, Bellevue, WA and can be reached out via phone at 541-623-0738.

Location: 1400 112Th Ave Se Ste 100, Bellevue, WA, 60607-2201
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699310284
Provider Name
Glacier Lake Wellness Pllc
Credential
Provider Entity Type
Organization
Address
1400 112Th Ave Se Ste 100, Bellevue, WA, 60607-2201
Phone Number
541-623-0738
Fax Number
Provider Enumeration Date
11/07/2019
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1400 112Th Ave Se Ste 100
City
Bellevue
State
Washington
Zip
98004-6901
Phone Number
541-623-0738
Fax Number
person
Provider Business Mailing Address Details
Address
1400 112Th Ave Se Ste 100
City
Bellevue
State
Washington
Zip
98004-6901
Phone Number
541-623-0738
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
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Definition
Definition to come...
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