Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00015306 | WA |
NPI | 1003958166 |
---|---|
Provider Name | Joan Marie Handelman |
First Address | Kenmore, WA 98028-4347 |
Second Address | Bellevue, WA 98005-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |