Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA 00011735 | WA |
NPI | 1003241746 |
---|---|
Provider Name | Trudy H Sanders |
First Address | Oak Harbor, WA 98277-0091 |
Second Address | Oak Harbor, WA 98277-4065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |