| NPI | 1346650330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKY BOULOM President 425-773-8553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH 00003526) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA60769473) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2018-03-17 |