Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60954673 | WA |
NPI | 1003472994 |
---|---|
Provider Name | Emily Augusta Taylor |
First Address | Bellingham, WA 98229-2026 |
Second Address | Bellingham, WA 98229-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 15/05/2019 |