Sky Valley Psychedelic Medical
NPI #1689386807 in Monroe, Washington
Provider Information
- NPI Number
- 1689386807
- Entity Type
- Organization
- Organization Name
- Sky Valley Psychedelic Medical
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Dec 19, 2022
- Last Updated
- Dec 23, 2022
Practice Location
- Address
- 101 E MAIN ST STE 209
- City
- Monroe
- State
- Washington
- ZIP Code
- 98272-1519
- Phone
- (360) 949-7555
Authorized Official
- Name
- JOHN PALMER LOVEJOY
- Title
- PHYSICIAN
- Phone
- (360) 949-7555
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
| Clinic/Center - Health Service — Health Service |
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