Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00010715 | WA |
NPI | 1003242819 |
---|---|
Provider Name | Ayrian Shalee Ott |
First Address | Kirkland, WA 98034-4920 |
Second Address | Bothell, WA 98011-3464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2013 |
Last Update Date | 25/09/2013 |