Individual
MRS. CARRIE M BURNSIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP,LAMP
Contact information
Practice address
13130 322ND AVE NE, DUVALL, WA 98019-7231
(206) 999-8768
Mailing address
13130 322ND AVE NE, DUVALL, WA 98019-7231
(206) 999-8768
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00012914
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134645
LABOR & INDUSTRIES
WA
Enumeration date
01/23/2007
Last updated
07/08/2007
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