Individual
MS. MARY JEAN TAHLEQUAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP,COMP,CNMT,SI
Contact information
Practice address
27615 108TH AVE SE, KENT, WA 98030-8768
(253) 850-2333
(253) 850-7164
Mailing address
27615 108TH AVE SE, KENT, WA 98030-8768
(253) 850-2333
(253) 850-7164
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010308
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00010308
MASSAGE LIC #
WA
Enumeration date
12/29/2006
Last updated
07/08/2007
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