Healthcare Provider Details

I. General information

NPI: 1376489534
Provider Name (Legal Business Name): SOUNDFLOW MYOFUNCTIONAL WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SE EVERETT MALL WAY STE B222
EVERETT WA
98208-8128
US

IV. Provider business mailing address

500 SE EVERETT MALL WAY STE B222
EVERETT WA
98208-8128
US

V. Phone/Fax

Practice location:
  • Phone: 425-205-5956
  • Fax:
Mailing address:
  • Phone: 425-205-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: NIDIA M FORMAN
Title or Position: OWNER
Credential: RDH, OMT
Phone: 425-205-5956