Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 225700000X | Massage Therapist | MA60792168 | WA |
NPI | 1013533066 |
---|---|
Provider Name | Aimee Kisaichi |
First Address | Seattle, WA 98117-3601 |
Second Address | Seattle, WA 98117-3601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 12/09/2021 |