Organization
EXPERIENCE MOMENTUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHODA CHAVEZ-NOWLAN (BILLING MANAGER, FINANCE)
(425) 776-0803
Entity
Organization
Contact information
Practice address
4030 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036
(425) 776-0803
(425) 776-0813
Mailing address
4030 ALDERWOOD MALL BLVD, LYNNWOOD, WA 98036
(425) 776-0803
(425) 773-0813
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
602579792
WA
225700000X
Massage Therapist
602579792
WA
Other
Enumeration date
11/29/2012
Last updated
03/13/2023
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