Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60159285 | WA |
NPI | 1013223742 |
---|---|
Provider Name | Brittany Louise Quon |
First Address | Edmonds, WA 98020-7230 |
Second Address | Edmonds, WA 98020-7230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2010 |
Last Update Date | 14/07/2020 |