Provider Demographics
NPI:1447681119
Name:NATURAL WELLNESS CENTER
Entity type:Organization
Organization Name:NATURAL WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FERCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:808-988-0800
Mailing Address - Street 1:2752 WOODLAWN DR STE 5-215
Mailing Address - Street 2:5-215
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1855
Mailing Address - Country:US
Mailing Address - Phone:808-988-0800
Mailing Address - Fax:866-503-4341
Practice Address - Street 1:2752 WOODLAWN DR STE 5-215
Practice Address - Street 2:5-215
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1855
Practice Address - Country:US
Practice Address - Phone:808-988-0800
Practice Address - Fax:866-503-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND-153175F00000X
HIND-229175F00000X
HIND-236175F00000X
HIND-252175F00000X
HIMD-3858208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty