| NPI | 1003332255 |
|---|---|
| Doing Business As | PNW MASSAGE & SPORT |
| Entity Type | Organization |
| Authorized Contact | KEVIN LEE VANDENBOSCH Owner/Lmp 206-383-3186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA60255380) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60546268) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2022-07-21 |