| NPI | 1356024228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LEE VANDENBOSCH Manager 206-519-0135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
| Additional Taxonomies | 133N00000X Nutritionist |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 225700000X Massage Therapist | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |