Individual
MR. BRYCE KUULEI DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, LMP
Contact information
Practice address
17833 1ST AVE S STE A, NORMANDY PARK, WA 98148-1713
(253) 330-8518
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
225700000X
Massage Therapist
Primary
MA00024952
WA
Other
Enumeration date
08/24/2006
Last updated
03/20/2023
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