Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 60183207 | WA |
NPI | 1003111816 |
---|---|
Provider Name | Sharai Elizabeth Kraus |
First Address | Spanaway, WA 98387-3046 |
Second Address | Tacoma, WA 98408-7625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2011 |
Last Update Date | 26/01/2011 |