| Bolesky Intention Inc | |
|
730 Gravity Way Buckley WA 98321-9587 | |
| (360) 829-1025 | |
| (360) 829-2805 |
| Full Name | Bolesky Intention Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 730 Gravity Way, Buckley, Washington |
| Authorized Official Name and Position | Karen L Bolesky (OWNER PRESIDENT CORP) |
| Authorized Official Contact | 3608291025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolesky Intention Inc 730 Gravity Way Buckley WA 98321-9587 Ph: (360) 829-1025 | Bolesky Intention Inc 730 Gravity Way Buckley WA 98321-9587 Ph: (360) 829-1025 |
| NPI Number | 1235329251 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 07/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235329251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LH00004290 (Washington) | Primary |
| 225700000X | Massage Therapist | MA00004219 (Washington) | Secondary |
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