Individual
DR. SKY BOULOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
15608 18TH PL W, LYNNWOOD, WA 98087-8800
(425) 773-8553
Mailing address
15608 18TH PL W, LYNNWOOD, WA 98087-8800
(425) 773-8553
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00003526
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252664
LABOR & INDUSTRIES
WA
Enumeration date
04/24/2007
Last updated
03/17/2018
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