Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00017158 | WA |
NPI | 1023183936 |
---|---|
Provider Name | Mrs. Brianna Margo Calkin |
First Address | Silverdale, WA 98383-8556 |
Second Address | Silverdale, WA 98383-8556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 19/01/2017 |