Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 16239 | OR |
NPI | 1003318346 |
---|---|
Provider Name | Emily Christensen |
First Address | Vancouver, WA 98682-8236 |
Second Address | Vancouver, WA 98682-8236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |