Individual
AMY M GUNDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
11108 WOODLAND AVE E STE A, PUYALLUP, WA 98373-5893
(253) 845-5358
(253) 845-5753
Mailing address
1312 9TH AVE NW, PUYALLUP, WA 98371-4024
(253) 845-5358
(253) 845-5753
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00025143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00025143
WA STATE LICENSE
WA
Enumeration date
09/11/2009
Last updated
09/11/2009
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