Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00014071 | WA |
NPI | 1013062611 |
---|---|
Provider Name | Sarah May Richards |
First Address | Vancouver, WA 98664-3157 |
Second Address | Vancouver, WA 98683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |