Organization
RAINIER ATHLETIC CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN VANDENBOSCH (MANAGER)
(206) 519-0135
Entity
Organization
Contact information
Practice address
819 PACIFIC AVE, TACOMA, WA 98402-5209
(206) 519-0135
Mailing address
819 PACIFIC AVE, TACOMA, WA 98402-5209
(206) 519-0135
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
133N00000X
Nutritionist
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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