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Organization
STEMWAVE NORTHWEST PLLC
Active
Organization
STEMWAVE NORTHWEST PLLC
Active
Other names
Lifetime Wellness Center NW
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE AMUNDSON DC (CO-OWNER)
(206) 409-9447
Entity
Organization
Contact information
Practice address
9500 ROOSEVELT WAY NE STE 302, SEATTLE, WA 98115-2253
(206) 409-9447
(904) 785-7798
Mailing address
9500 ROOSEVELT WAY NE STE 302, SEATTLE, WA 98115-2253
(206) 409-9447
(904) 785-7798
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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