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Individual

ALEKSEY BOGDANOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
3021 NE 72ND DR, #15, VANCOUVER, WA 98661-7300
(360) 260-6903
(360) 260-4849
Mailing address
305 COUNCIL BLUFFS WAY, VANCOUVER, WA 98661-7509
(360) 773-2602
(360) 260-4849

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60609990
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA60609990
STATE MASSAGE LICENSE
WA
Enumeration date
11/14/2016
Last updated
11/14/2016
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