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Organization
SACRED LIFE LLC
Active
Organization
SACRED LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN SOBOVOY RN (OWNER)
(360) 721-4303
Entity
Organization
Contact information
Practice address
11412 NE 50TH AVE, VANCOUVER, WA 98686-4418
(360) 699-6411
Mailing address
11412 NE 50TH AVE, VANCOUVER, WA 98686-4418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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