| Organization Name: | LA CONNER HEALTH AND WELLNESS LLC |
| NPI Number: | 1720356876 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILBERT DANIEL JAMES (DIRECTOR) |
| Mailing Address: | 413 Morris St. La Conner |
| State: | WA US |
| Postal Code: | 98257 |
| Phone Number: | 3604668842 |
| Fax Number: | 3604661418 |
| NPI Enumeration Date: | 12/05/2011 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD00036777 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |