Individual
MISHELLE MCLEOD BAUMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8221 NE HAZEL DELL AVE, VANCOUVER, WA 98665-8153
(360) 773-2715
Mailing address
8221 NE HAZEL DELL AVE, VANCOUVER, WA 98665-8069
(360) 773-2715
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024219
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00024219
MASSAGE PRACTITIONER
WA
Enumeration date
10/03/2008
Last updated
07/18/2012
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