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Organization

EASTSIDE IDEAL HEALTH ISSAQUAH, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOEL SOUTHWELL DC, MS (OWNER/CHIROPRACTIC PHYSICIAN)
(425) 800-6881
Entity
Organization

Contact information

Practice address
1495 NW GILMAN BLVD STE 12, ISSAQUAH, WA 98027-5328
(425) 800-6881
(425) 392-1039
Mailing address
1525 NW MALL ST, ISSAQUAH, WA 98027-8947
(425) 800-6881
(425) 392-1039

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Enumeration date
02/13/2019
Last updated
12/21/2021
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