| NPI | 1356591291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOUALOY MANIVANH ABANDO Lmp 206-992-6798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: WA MA00024146) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2008-09-29 |