Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 60574061 | WA |
NPI | 1003285529 |
---|---|
Provider Name | Tianna Marie Hull |
First Address | Seattle, WA 98125-4039 |
Second Address | Seattle, WA 98126-3993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 15/09/2015 |