Individual
ALEJANDRO RAY SOUTHARD-RESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2902 164TH ST SW SUITE D1, LYNNWOOD, WA 98087-8801
(425) 745-2500
Mailing address
1325 191ST PL SE, BOTHELL, WA 98012-9719
(206) 327-4702
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60620179
WA
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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