Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60257958 | WA |
NPI | 1003188319 |
---|---|
Provider Name | Dawn Kelly Owens |
First Address | Milton, WA 98354-9382 |
Second Address | Milton, WA 98354-9382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2012 |
Last Update Date | 01/02/2012 |