Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 00011065 | WA |
NPI | 1003106030 |
---|---|
Provider Name | Helen M Shaudys |
First Address | Duvall, WA 98019-0171 |
Second Address | Bellevue, WA 98007-5229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 11/04/2011 |