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GLACIER LAKE WELLNESS PLLC
NPI 1699310284
Nurse Practitioner - Psychiatric/Mental Health in Bellevue, WA

Active since November 07, 2019
1400 112TH AVE SE STE 100, BELLEVUE, WA 98004(541) 623-0738 Get Directions Write a Review

NPPES record last updated: July 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 19, 2022, Dec 9, 2019, Nov 7, 2019 (3 updates tracked since 2019).

About Glacier Lake Wellness Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLACIER LAKE WELLNESS PLLC (NPI 1699310284) is a healthcare organization registered as a psychiatric/mental health in Bellevue, Washington and active in the NPI registry since November 2019. The organization lists Thomas Moore, President, as its authorized official.

NPPES Registry Identity

NPI1699310284
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameGLACIER LAKE WELLNESS PLLC
Location Address1400 112TH AVE SE STE 100Bellevue, WA 98004-6901
Mailing Address159 N Sangamon St Ste 200Chicago, IL 60607-2201 · (309) 397-2415
Phone(541) 623-0738
Organization SubpartNo
Authorized OfficialThomas MoorePresident · (541) 345-1722
Enumeration DateNovember 7, 2019
Last NPPES UpdateJuly 19, 20223 updates tracked since enumeration
NPPES CertifiedJuly 19, 2022
✔ NPI 1699310284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1400 112TH AVE SE STE 100, Bellevue, WA 98004
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOMMER SEITZ LPC
Counselor (Mental Health)
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (503) 208-1030
DEVINE CARE SUPPORTED LIVING CORPORATION
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (253) 240-7463
VITALOGIC HEALTHCARE SOLUTIONS LLC
Home Health
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (206) 586-3898
MS. CLAIRE PASTOR M.D.
Psychiatry & Neurology (Psychiatry)
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (425) 462-9511
TELEEMON BEHAVIORAL HEALTH SERVICES
Clinic/Center (Mental Health (Including Community Mental Health Center))
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (425) 615-8960
PREMIER THERAPEUTIC EXPERIENCE
Marriage & Family Therapist
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (507) 254-7893
CEDAR NEARY MD
Psychiatry & Neurology (Psychiatry)
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (206) 506-0636
CENTER FOR COUNSELING AND WELLBEING
Clinic/Center (Mental Health (Including Community Mental Health Center))
1400 112TH AVE SE STE 100
BELLEVUE, WA 98004
King County (214) 205-5004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glacier Lake Wellness PLLC's NPI number?

The NPI number for Glacier Lake Wellness PLLC is 1699310284. It was assigned to this organization in the NPPES registry on November 7, 2019.

Where is Glacier Lake Wellness PLLC located?

Glacier Lake Wellness PLLC is located at 1400 112th Ave SE Ste 100, Bellevue, WA 98004. The listed phone number is (541) 623-0738.

What is Glacier Lake Wellness PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Glacier Lake Wellness PLLC was last updated on July 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.