Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00020213 | WA |
NPI | 1003944059 |
---|---|
Provider Name | Deanna Irene Clasby |
First Address | Bellingham, WA 98225-4728 |
Second Address | Bellingham, WA 98225-4728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 10/04/2017 |