Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00023132 | WA |
NPI | 1003049305 |
---|---|
Provider Name | Natalia Maria Carter |
First Address | Port Hadlock, WA 98339-0191 |
Second Address | Kingston, WA 98346-9454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2009 |
Last Update Date | 02/09/2009 |