Individual
BRIAN VAN OVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16315 NE 23RD ST, VANCOUVER, WA 98684-8665
(360) 882-0767
(360) 885-2580
Mailing address
13119 NE 89TH ST, VANCOUVER, WA 98682
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61468746
WA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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