Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 60486806 | WA |
NPI | 1013448851 |
---|---|
Provider Name | Kate Burton |
First Address | Woodinville, WA 98072-8519 |
Second Address | Woodinville, WA 98072-8519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 23/03/2017 |