Organization
NORTHWEST FUNCTIONAL NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI GEPNER RD, CD (OWNER)
(425) 588-0480
Entity
Organization
Contact information
Practice address
19125 N CREEK PKWY STE 120, BOTHELL, WA 98011-8000
(425) 588-0480
Mailing address
PO BOX 821092, KENMORE, WA 98028-0999
(425) 588-0480
(833) 464-0125
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2020
Last updated
09/21/2021
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