Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60268905 | WA |
NPI | 1003329012 |
---|---|
Provider Name | Christine Kendra |
First Address | Seattle, WA 98115-5542 |
Second Address | Seattle, WA 98115-5542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2017 |
Last Update Date | 13/11/2017 |