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Individual

MS. CHRISTINE LOUISE MOODY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
7914 MARTIN WAY E, STE 8, OLYMPIA, WA 98516-5728
(360) 339-7177
Mailing address
2567 25TH LOOP SE, LACEY, WA 98503-3812
(360) 791-7008

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60181438
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0272790
STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES
WA
Enumeration date
10/13/2011
Last updated
10/13/2011
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