Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00022812 | WA |
NPI | 1013089416 |
---|---|
Provider Name | Melissa Christine Delaney |
First Address | Tacoma, WA 98422-3113 |
Second Address | Lakewood, WA 98499-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |