| NPI | 1407074792 |
|---|---|
| Other Name | WELLNESS ONE OF EASTGATE |
| Entity Type | Organization |
| Authorized Contact | STEVEN P THAIN Owner 425-644-8386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MA00019552) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |