Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60853671 | WA |
NPI | 1013485317 |
---|---|
Provider Name | Genesis P Ramirez |
First Address | Monroe, WA 98272-1457 |
Second Address | Monroe, WA 98272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 05/11/2018 |