Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 60354041 | WA |
NPI | 1013355239 |
---|---|
Provider Name | Carol Thuy Thanh Bui |
First Address | Tacoma, WA 98405 |
Second Address | Tacoma, WA 98402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2013 |
Last Update Date | 10/06/2013 |