Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60236613 | WA |
NPI | 1013299528 |
---|---|
Provider Name | Mrs. Marnella Lee Ann Manier |
First Address | Bellingham, WA 98229 |
Second Address | Bellingham, WA 98226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2011 |
Last Update Date | 12/09/2011 |