Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60297105 | WA |
NPI | 1003216037 |
---|---|
Provider Name | Michele Anne Dean |
First Address | Seattle, WA 98144 |
Second Address | Seattle, WA 98144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2014 |
Last Update Date | 27/08/2014 |