| NPI | 1780831917 |
|---|---|
| Former Legal Business Name | PROACTIVE NUTRITION |
| Entity Type | Organization |
| Authorized Contact | SALLY L HARA Owner 425-814-8443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 602401604) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-08-19 |