Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60241751 | WA |
NPI | 1013293992 |
---|---|
Provider Name | Briana S Negrete |
First Address | Yakima, WA 98902-4877 |
Second Address | Yakima, WA 98902-4877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2011 |
Last Update Date | 24/10/2011 |