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General NPI Number Information
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NPI Number | 1356730204
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Entity Type | Organization
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Legal Business Name | EVERYBODY STIMS, LLC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 6710 NE 144TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-2096
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Country | US
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Telephone | 360-608-5143
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Fax |
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Provider Business Mailing Address
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Address Line | 6710 NE 144TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-2096
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Country | US
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Telephone | 360-608-5143
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JOANNA BLANCHARD
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Credential | MPT
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Telephone | 360-608-5143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00003286
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License Number State | WA
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