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Individual
SAMARA R THELEN
Active
Individual
SAMARA R THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00022106
WA
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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