Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60019073 | WA |
NPI | 1013334507 |
---|---|
Provider Name | Rachael Louise Romero |
First Address | Vancouver, WA 98661 |
Second Address | Vancouver, WA 98662-6104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 24/03/2014 |