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Organization
HERITAGE BUILDING LLC
Active
Organization
HERITAGE BUILDING LLC
Active
Other names
PACIFIC COMPLEMENTARY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LOUIS FAIOLA M.D. (PRESIDENT)
(360) 704-2362
Entity
Organization
Contact information
Practice address
4001 HARRISON AVE NW, STE 102, OLYMPIA, WA 98502-5084
(360) 956-3627
(360) 350-1445
Mailing address
4001 HARRISON AVE NW, STE 102, OLYMPIA, WA 98502-5084
(360) 740-0888
(360) 350-1445
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH00034866
WA
208100000X
Physical Medicine & Rehabilitation Physician
AC00000244
WA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
225700000X
Massage Therapist
MA60043686
WA
Other
Enumeration date
12/02/2013
Last updated
04/01/2014
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