# RESTORE WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669060760
- **Authorized official:** MS. SUANNE F SIKKEMA CNS (OWNER, NUTRITIONIST)
- **Authorized official phone:** (907) 830-9877

## Contact information

- **Practice address:** 3407 WILLOW ST, ANCHORAGE, AK 99517-2106
- **Practice address phone:** (907) 830-9877
- **Mailing address:** PO BOX 91014, ANCHORAGE, AK 99509-1014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | — | — | Yes |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |

## Other

- **Enumeration date:** 01/05/2021
- **Last updated:** 04/20/2021