Amanda Chantel Ullom

NPI #1215361605 in Bothell, Washington

Provider Information

NPI Number: 1215361605
Entity Type: Individual
Name: Amanda Chantel Ullom
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Aug 21, 2013
Last Updated: Aug 21, 2013

Practice Location

Address: 11801 NE 160TH ST
Address 2: SUITE D
City: Bothell
State: Washington
ZIP Code: 98011-4106
Phone: (206) 850-6692

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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