Organization · Type 2 NPI

Sky Valley Psychedelic Medical

Health Service Clinic/Center · Monroe, WA

NPI number 1689386807 Active

Practice location

101 E Main St Ste 209
Monroe, WA 98272-1519

Call (360) 949-7555 Map

Mailing address

40016 145th Pl SE
Gold Bar, WA 98251-9471

Specialties and licenses

Taxonomy	Code	License
Clinic/Center	261Q00000X	None listed
Health Service Clinic/Center Primary	261QH0100X	None listed

Health Service Clinic/Center: Definition to come...

3 other providers at this address

Joan Lumsden, LMHCMental Health Counselor Monroe, WA NPI 1851911143
Logan Donovon Smith, BSStudent in an Organized Health Care Education/Training Program Monroe, WA NPI 1235713009
Rene TobinMental Health Counselor Monroe, WA NPI 1144966995

Other health service clinic/center providers in Monroe

See all in Monroe →

NPI record

NPI: 1689386807
Entity type: Organization (Type 2)
Issued: Dec 19, 2022
Last updated: Dec 23, 2022
Status: Active

Other names

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Sky Valley Psychedelic Medical · doing business as
Sky Valley Psychedelic Medical · doing business as

Authorized official

John Palmer Lovejoy
Physician
(360) 949-7555

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1689386807

Sky Valley Psychedelic Medical's National Provider Identifier is 1689386807, issued on Dec 19, 2022. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Monroe, WA. The record was last updated on Dec 23, 2022.