GLACIER LAKE WELLNESS PLLC

BELLEVUE, WA
NPI1699310284
Entity TypeOrganization
Authorized ContactTHOMAS MOORE
President
541-345-1722
Organization Subpart ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date2019-11-07
Last Update Date2022-07-19
Business Address
GLACIER LAKE WELLNESS PLLC
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004-6901
Phone number: 541-623-0738
Mailing Address
GLACIER LAKE WELLNESS PLLC
159 N SANGAMON ST STE 200
CHICAGO, IL 60607-2201
Phone number: 309-397-2415
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