Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60471823 | WA |
NPI | 1003227778 |
---|---|
Provider Name | Karl James Perkins |
First Address | Seattle, WA 98103-8017 |
Second Address | Seattle, WA 98103-8017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2014 |
Last Update Date | 15/05/2014 |