| NPI | 1215701404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DEDOMENICO Owner 425-861-6273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 133V00000X Dietitian, Registered | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-17 |