Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00022876 | WA |
NPI | 1013187608 |
---|---|
Provider Name | Maitram Nguyen |
First Address | Seattle, WA 98144-3910 |
Second Address | Seattle, WA 98144-3910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 10/03/2008 |