Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | ||
Y | 225700000X | Massage Therapist | WA |
NPI | 1013495142 |
---|---|
Provider Name | Cynthia Karel Torales |
First Address | Connell, WA 99326-0995 |
Second Address | Connell, WA 99326-5102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2018 |
Last Update Date | 31/07/2018 |