| NPI | 1477684231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK W PETHERAM Owner 206-842-2702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 3554) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 22433) |
| 111N00000X Chiropractor (Licence: WA 3595) | |
| 111N00000X Chiropractor (Licence: CA 22670) | |
| 225700000X Massage Therapist (Licence: WA MA00014485) | |
| 225700000X Massage Therapist (Licence: WA MA00019967) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-12-05 |