Individual
EMILY DIANNE BOUGHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3712 9TH ST SW STE A1, PUYALLUP, WA 98373-3564
(253) 880-7004
Mailing address
2358 S HOSMER ST, TACOMA, WA 98405-3149
(253) 468-4124
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
61508749
WA
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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