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
—
—
225700000X
Massage Therapist
MA60043686
WA
Other
Enumeration date
12/02/2013
Last updated
04/01/2014
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