Generally no. Patients can most often self refer. There are times where if you have been working with another provider extensively on your conditions where a referral can be supportive just to have the full clinical context of why you are establishing care and medical records included in the referral. It is not required to have this to establish though. 

No! We do encourage everyone having a primary care provider. Many of our specialist care providers can also provide primary care and if they cannot they can also support you in finding the right primary care provider if you are in need of one. 

In need of a primary care provider in Seattle, Washington, or California? Learn more →

No, we are out of network however we can provide superbills upon request.

No, we work with people in many phases of work up and exploration of symptoms. Our clinicians can work with you through a diagnosis process if you do not yet have that prior to establishing care.

Small Intestinal Bacterial Overgrowth (SIBO) is a condition in which excessive bacteria accumulate in the small intestine, where bacterial levels are normally low compared to the colon. This overgrowth can interfere with digestion and nutrient absorption, leading to symptoms such as bloating, gas, abdominal discomfort, diarrhea or constipation, and sometimes fatigue or brain fog. SIBO is often associated with motility disorders, post-infectious changes, dysautonomia, or other conditions that slow intestinal movement.

Irritable bowel syndrome is often misdiagnosed and often may have underlying cause with SIBO/SIFO/IFO

imilarly to SIBO, SIFO/IFO is the overgrowth of fungus rather than bacterial. Often SIBO and SIFO/IFO coincide together. If you have undergone traditional SIBO treatment with minimal resolution of symptoms and you were not tested for a fungal component or treated with an antifungal adjacent to SIBO treatment this may be a missing component to your condition.

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent abdominal pain associated with changes in bowel habits, including diarrhea, constipation, or a mix of both. Symptoms often include bloating, gas, and a sensation of incomplete evacuation, and they can fluctuate with stress, diet, hormonal changes, and gut-brain signaling. While IBS does not cause structural damage to the intestines, it can significantly impact quality of life and is often linked to altered motility, visceral hypersensitivity, and microbiome imbalance. It is often an umbrella diagnosis that can be caused by dysbiosis, MCAS or other triggers and we work to uncover the root cause.

Inflammatory Bowel Disease (IBD) is a chronic autoimmune condition that causes ongoing inflammation in the gastrointestinal tract. The two main forms are Crohn's disease, which can affect any part of the digestive tract, and Ulcerative colitis, which primarily affects the colon and rectum. Symptoms may include abdominal pain, persistent diarrhea (sometimes with blood), fatigue, weight loss, and nutrient deficiencies, and management typically involves immune-modulating medications and close medical monitoring.

Stool testing or breath testing are both common options when evaluating the digestive system. Blood testing often is also part of evaluation to also monitor for nutritional status, intestinal absorption and inflammatory markers. At times we may refer to gastroenterology for colonoscopy, endoscopy or other work up. There are also sometimes indications for other imaging tests that we may refer for.

Treatment can vary based on condition. At times we may utilize medications, herbs, supplements or a combination of them. Where indicated treatments such as visceral manipulation or acupuncture may also be recommended.