Individual
BRENDA J WINDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA 60114035
WA
173C00000X
Reflexologist
NOT REQUIRED
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0257488
L&I PROVIDER
WA
Enumeration date
11/05/2009
Last updated
10/25/2010
Update your record
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