Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00013357 | WA |
NPI | 1003941451 |
---|---|
Provider Name | Ms. Brandy Layne Mcdaniel |
First Address | Tacoma, WA 98406-7796 |
Second Address | Tacoma, WA 98406-7796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 25/07/2014 |