Organization
SKY VALLEY PSYCHEDELIC MEDICAL
Active
Other names
Sky Valley Psychedelic Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PALMER LOVEJOY (PHYSICIAN)
(360) 949-7555
Entity
Organization
Contact information
Practice address
101 E MAIN ST STE 209, MONROE, WA 98272-1519
(360) 949-7555
Mailing address
40016 145TH PL SE, GOLD BAR, WA 98251-9471
(707) 239-6190
(707) 239-6190
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
12/23/2022
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