Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60129817 | WA |
NPI | 1013234749 |
---|---|
Provider Name | Robbyn K Lattea |
First Address | Auburn, WA 98001-3115 |
Second Address | Auburn, WA 98001-3115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2010 |
Last Update Date | 20/04/2010 |