| NPI | 1659688554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKY R GOUDEY Owner Supervisor 360-533-2252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00002582) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2018-04-23 |