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Individual
MRS. LEAH EVE CLARK
Active
Individual
MRS. LEAH EVE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00011463
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00011463
LMP
WA
Enumeration date
02/17/2011
Last updated
10/10/2011
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