Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 60609139 | WA |
NPI | 1013374297 |
---|---|
Provider Name | Sara Epperly |
First Address | Kennewick, WA 99336-4794 |
Second Address | Richland, WA 99352-9701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2016 |
Last Update Date | 20/01/2016 |