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NPI Code Detail

MEDICARE: DREAM CLINIC

MEDICARE: DREAM CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA60103537WA

General Provider Information

NPI Number : 1578955290
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREAM CLINIC
Provider Business Mailing Address
First Line : 916 NE 65TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98115-5542
Country : US
Telephone Number : 206-267-0863
Fax Number :
Provider Business Practice Location Address
First Line : 916 NE 65TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98115-5542
Country : US
Telephone Number : 206-267-0863
Fax Number :
Authorized Official
Title or Position : CLINIC MANAGER
Name : MR. JIMMY KRIEGER
Credential :
Telephone Number : 206-267-0863
Provider Enumeration Date : 03/04/2015
Last Update Date : 03/04/2015

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Directions to “DREAM CLINIC ” Practice Location

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