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Organization
PEACH WILLOW LLC
Active
Organization
PEACH WILLOW LLC
Active
Other names
Peach Willow Spa
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GOODE (GENERAL MANAGER)
(360) 773-5110
Entity
Organization
Contact information
Practice address
9015 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2536
(360) 773-5110
Mailing address
9015 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2536
(360) 773-5110
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
89329
WA
Other
Enumeration date
02/03/2018
Last updated
06/11/2019
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