Healthcare Provider Details

I. General information

NPI: 1447121074
Provider Name (Legal Business Name): BLOOM BEAUTY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 S TACOMA WAY STE 205
TACOMA WA
98499-4595
US

IV. Provider business mailing address

8811 S TACOMA WAY STE 205
TACOMA WA
98499-4595
US

V. Phone/Fax

Practice location:
  • Phone: 206-310-8686
  • Fax:
Mailing address:
  • Phone: 206-310-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SIEW YENG CHAI
Title or Position: NURSE PRACTITIONER - OWNER
Credential: NP
Phone: 206-310-8686