Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00004732 | WA |
NPI | 1003080060 |
---|---|
Provider Name | Mary Ann Zenger |
First Address | Snohomish, WA 98290-2929 |
Second Address | Everett, WA 98208-7203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2008 |
Last Update Date | 10/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0235088 | DEPT OF L&I (01) | WA |
237869 | L&I (01) | WA |
5305ZE | REGENCE (01) | WA |
7568ZE | REGENCE (01) | WA |
8947201 | L&I CRIME (01) | WA |
8948048 | L&I CRIME VICTIMS (01) | WA |