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General NPI Number Information
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NPI Number | 1447121074
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Entity Type | Organization
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Legal Business Name | BLOOM BEAUTY & WELLNESS LLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 8811 S TACOMA WAY STE 205
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City | TACOMA
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State | WA
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Zip | 98499-4595
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Country | US
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Telephone | 206-310-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 8811 S TACOMA WAY STE 205
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City | TACOMA
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State | WA
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Zip | 98499-4595
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Country | US
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Telephone | 206-310-8686
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER - OWNER
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Name | SIEW YENG CHAI
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Credential | NP
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Telephone | 206-310-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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