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Organization
NORTHWEST SPORTS PERFORMANCE
Active
Organization
NORTHWEST SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN VANDENBOSCH LMT (LMT)
(206) 383-3186
Entity
Organization
Contact information
Practice address
15916 93RD AVE E, PUYALLUP, WA 98375-6718
(206) 383-3186
Mailing address
15916 93RD AVE E, PUYALLUP, WA 98375-6718
(206) 383-3186
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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