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Organization

I-WAS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEREK DOUGLAS (FOUNDER)
(970) 746-6387
Entity
Organization

Contact information

Practice address
523 N PINE ST., GUNNISON, CO 81230-2615
(970) 746-6387
(970) 832-9287
Mailing address
4 WILLOW LN, GUNNISON, CO 81230-9762
(970) 832-9287

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
246Z00000X
Other Specialist/Technologist
247200000X
Other Technician
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
374K00000X
Religious Nonmedical Practitioner
374U00000X
Home Health Aide
376K00000X
Nurse's Aide

Other

Enumeration date
06/28/2023
Last updated
08/18/2023
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