Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013382258 |
---|---|
Provider Name | Jonathan Mckee |
First Address | Spokane, WA 99223-7709 |
Second Address | Spokane, WA 99223-7709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2015 |
Last Update Date | 12/12/2015 |