Organization
GEM MAGIC HEALING, INC
Active
Parent organization
GEM MAGIC HEALING, INC
Other names
Three Moon Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEM MAGIC HEALING, INC
Authorized official
DR. JENNIFER A. MCCOLLUM ND (MEDICAL DIRECTOR)
(206) 838-3879
Entity
Organization
Contact information
Practice address
19625 62ND AVE S, C-104, KENT, WA 98032-1103
(206) 838-3878
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 100, LOS ANGELES, CA 90077-1726
(310) 474-9809
(888) 431-8819
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
08/28/2012
Last updated
10/05/2015
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