Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60129379 | WA |
NPI | 1013247410 |
---|---|
Provider Name | Ms. Patricia M. Little |
First Address | Seattle, WA 98144-2550 |
Second Address | Seattle, WA 98144-2550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2010 |
Last Update Date | 15/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA60129379 | L.M.P. LICENSE (01) | WA |