Healthcare Provider Details

I. General information

NPI: 1215831490
Provider Name (Legal Business Name): SOUND REGENERATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 CAPITAL MALL DR SW STE B3A
OLYMPIA WA
98502-8696
US

IV. Provider business mailing address

PO BOX 11374
OLYMPIA WA
98508-1374
US

V. Phone/Fax

Practice location:
  • Phone: 360-280-2976
  • Fax: 888-411-8529
Mailing address:
  • Phone: 360-280-2976
  • Fax: 888-411-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALLISON GRAY
Title or Position: REVENUE CYCLE ADMINISTRATOR
Credential:
Phone: 360-970-4336