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Organization

ANJILLIA DIBAUM

Active
Other names
Kula Movement
Organization subpart
No

Provider details

NPI number
Authorized official
MISS ANGELA MAE BAUMGARDNER (OWNER)
(206) 972-2999
Entity
Organization

Contact information

Practice address
5340 BALLARD AVE NW, SEATTLE, WA 98107-4060
(206) 972-2999
Mailing address
5340 BALLARD AVE NW, SEATTLE, WA 98107-4060
(206) 972-2999

Taxonomy

Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
133N00000X
Nutritionist
WA
171100000X
Acupuncturist
WA
175F00000X
Naturopath
WA
225700000X
Massage Therapist
MA
261QC1500X
Community Health Clinic/Center
Primary
602902322
WA

Other

Enumeration date
03/12/2014
Last updated
03/12/2014
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