Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60363513 | WA |
NPI | 1003247636 |
---|---|
Provider Name | Dshawn Field |
First Address | Seattle, WA 98122-2065 |
Second Address | Seattle, WA 98122-2065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2013 |
Last Update Date | 08/12/2013 |