Organization
FUNCTIONAL MEDICINE NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY A ILLER ND (MEMBER/OWNER)
(206) 268-0397
Entity
Organization
Contact information
Practice address
8010 15TH AVE NW, SUITE D, SEATTLE, WA 98117
(206) 268-0397
(206) 518-9225
Mailing address
8010 15TH AVE NW, SUITE D, SEATTLE, WA 98117
(206) 268-0397
(206) 518-9225
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
NT60115399
WA
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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