Organization
ADVANCED WELLNESS CONNECTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY K HALLER MA, GCFP, LMP (OWNER)
(425) 282-0406
Entity
Organization
Contact information
Practice address
981 POWELL AVE SW STE 130, RENTON, WA 98057-2990
(425) 282-0406
(425) 282-0404
Mailing address
981 POWELL AVE SW STE 130, RENTON, WA 98057-2990
(425) 282-0406
(425) 282-0404
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MA 00008877
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649358573
NPI INDIVIDUAL NUMBER
—
Enumeration date
04/27/2011
Last updated
04/27/2011
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