| NPI | 1689386807 |
|---|---|
| Doing Business As | SKY VALLEY PSYCHEDELIC MEDICAL |
| Entity Type | Organization |
| Authorized Contact | JOHN PALMER LOVEJOY Physician 360-949-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-23 |