Individual
ANGELIKA M PETROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5514 NE 107TH AVE, SUITE 101, VANCOUVER, WA 98662-6346
(360) 254-0400
(360) 254-9022
Mailing address
PO BOX 821477, VANCOUVER, WA 98682-0033
(360) 910-0040
(360) 254-9022
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00017403
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169505
L&I
WA
Enumeration date
05/03/2007
Last updated
07/08/2007
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