Individual
SCOTT WAMBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
450 LECKLER CREEK RD, CASTLE ROCK, WA 98611-9264
(503) 781-4606
Mailing address
450 LECKLER CREEK RD, CASTLE ROCK, WA 98611-9264
(503) 781-4606
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
21344
OR
172M00000X
Mechanotherapist
Primary
60547514
WA
Other
Enumeration date
09/07/2015
Last updated
09/07/2015
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