Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA60253184 | WA |
NPI | 1013319409 |
---|---|
Provider Name | Toni James |
First Address | Redmond, WA 98052-5536 |
Second Address | Redmond, WA 98052-5536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2014 |
Last Update Date | 17/09/2014 |