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Individual
MS. SUNNY WALLIS BIRDSTONE
Active
Individual
MS. SUNNY WALLIS BIRDSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA9942
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007372197
AETNA
WA
01
—
0137636
WA LABOR AND INDUSTRIES
WA
01
—
218248218247
PREMERA BLUE CROSS
WA
01
—
5316WA
REGENCE BLUE SHIELD
WA
Enumeration date
11/28/2006
Last updated
07/08/2007
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