Individual
AMANDA CHANTEL ULLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11801 NE 160TH ST, SUITE D, BOTHELL, WA 98011-4106
(206) 850-6692
Mailing address
PO BOX 2837, WOODINVILLE, WA 98072-2837
(206) 850-6692
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00024803
WA
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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