Individual
DIMITRI PANAGIS AGGELIDAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
11505 BURNHAM DR, GIG HARBOR, WA 98332-9173
(253) 858-5152
(253) 858-5153
Mailing address
11505 BURNHAM DR, GIG HARBOR, WA 98332-9173
(253) 858-5152
(253) 858-5153
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61044627
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
N/A
WA
Enumeration date
12/10/2021
Last updated
12/21/2021
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