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Organization

RESTORATION THERAPIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELE A LEWIS LMP (OWNDER)
(360) 860-0589
Entity
Organization

Contact information

Practice address
423 SW SEDGWICK RD, SUITE 101, PORT ORCHARD, WA 98367-6425
(360) 860-0589
Mailing address
PO BOX 7186, BONNEY LAKE, WA 98391-0930

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA60178088
WA

Other

Enumeration date
10/30/2014
Last updated
10/30/2014
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