Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00018109 | WA |
NPI | 1013156165 |
---|---|
Provider Name | Tonya Lee Casali |
First Address | Bellingham, WA 98225-2915 |
Second Address | Bellingham, WA 98225-2915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2009 |
Last Update Date | 12/02/2009 |