Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60293100 | WA |
NPI | 1013254796 |
---|---|
Provider Name | Ms. Geraldine Pearl Bright |
First Address | Kirkland, WA 98034-6933 |
Second Address | Kirkland, WA 98034-6933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2013 |
Last Update Date | 15/01/2013 |