| Formo Enterprises, Inc | |
|
17401 135th Ave Ne, Suite #4, Woodinville, WA 98072-6825 | |
| (425) 483-2320 | |
| (425) 424-3256 |
| Full Name | Formo Enterprises, Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Nutrition |
| Location | 17401 135th Ave Ne, Woodinville, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275899460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NN1001X | Chiropractor - Nutrition | CH00034796 (Washington) | Primary |
| Provider Name | Kimberly R Formo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336330877 PECOS PAC ID: 9638265986 Enrollment ID: I20071017000666 |
| Mailing Address | Practice Location Address |
|---|---|
| Formo Enterprises, Inc 17401 135th Ave Ne, Suite #4, Woodinville, WA 98072-6825 Ph: (425) 483-2320 | Formo Enterprises, Inc 17401 135th Ave Ne, Suite #4, Woodinville, WA 98072-6825 Ph: (425) 483-2320 |
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Myron Gudmundson, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 17630 140th Ave Ne, Ste A, Woodinville, WA 98072 Phone: 425-398-3900 Fax: 425-398-3907 | |
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