NORTHWEST FUNCTIONAL NUTRITION, LLC
NPI 1760022156
Clinic/Center in Bothell, WA

Q: What is Northwest Functional Nutrition, LLC's NPI number?

The NPI number for Northwest Functional Nutrition, LLC is 1760022156. It was assigned to this organization in the NPPES registry on January 14, 2020.

Q: What is Northwest Functional Nutrition, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since January 14, 2020

19125 N CREEK PKWY STE 120, BOTHELL, WA 98011(425) 588-0480 Get Directions Write a Review

NPPES record last updated: September 21, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 21, 2021, Sep 16, 2021, Jan 14, 2020 (3 updates tracked since 2020).

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About Northwest Functional Nutrition, Llc NPPES

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

NORTHWEST FUNCTIONAL NUTRITION, LLC (NPI 1760022156) is a healthcare organization registered as a clinic/center in Bothell, Washington and active in the NPI registry since January 2020. The organization maintains a secondary practice location in Woodinville and lists Nikki Gepner, Owner, as its authorized official.

NPPES Registry Identity

NPI1760022156

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameNORTHWEST FUNCTIONAL NUTRITION, LLC

Location Address19125 N CREEK PKWY STE 120Bothell, WA 98011-8000

Mailing AddressPo Box 821092Kenmore, WA 98028-0999 · (425) 588-0480 · Fax (833) 464-0125

Phone(425) 588-0480

Organization SubpartNo

Authorized OfficialNikki GepnerOwner · (425) 588-0480

Enumeration DateJanuary 14, 2020

Last NPPES UpdateSeptember 21, 20213 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2021

✔ NPI 1760022156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

19125 N CREEK PKWY STE 120, Bothell, WA 98011

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Secondary Practice Location 1

Location 116818 140th Ave NEWoodinville, WA 98072-9001 · Phone (425) 588-0480 · Fax (833) 464-0125

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location NPPES 8

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

MR. JOHN MICHAEL ULYSSES DULKO RN

Student in an Organized Health Care Education/Training Program