Individual
MRS. COURTNEY JANELLE MADLUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
15324 MAIN ST E STE B, SUMNER, WA 98390-2698
(253) 863-5323
(253) 863-2034
Mailing address
15324 MAIN ST E STE B, SUMNER, WA 98390-2698
(253) 863-5323
(253) 863-2034
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019055
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183864
INT'L MASSAGE ASSOC#
WA
01
—
602414363
TAX ID#
WA
01
—
91-1580839
GROUP TAX ID#
WA
01
—
MA00019055
WA LICENSE CREDENTIAL#
WA
Enumeration date
11/21/2006
Last updated
07/08/2007
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