Organization
VITALITY CORPORATION
Active
Other names
Renaissance Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
RHEA BUCASAS D.C. (OWNER)
(425) 257-0177
Entity
Organization
Contact information
Practice address
2824 GRAND AVE STE 102, EVERETT, WA 98201-3482
(425) 257-0177
Mailing address
2824 GRAND AVE STE 102, EVERETT, WA 98201-3482
(425) 257-0177
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G8935706
—
WA
Enumeration date
05/08/2019
Last updated
06/11/2019
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