Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA000010954 | WA |
NPI | 1013215292 |
---|---|
Provider Name | Rebecca Mcaferty |
First Address | Olympia, WA 98501-3157 |
Second Address | Olympia, WA 98501-3157 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2011 |
Last Update Date | 11/03/2011 |