Individual
GIOVANNI COSTALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
22108 52ND AVE W, MOUNTLAKE TERRACE, WA 98043-4007
(206) 550-2205
Mailing address
22108 52ND AVE W, MOUNTLAKE TERRACE, WA 98043-4007
(206) 550-2205
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00018033
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219023
STATE LI
WA
Enumeration date
05/22/2007
Last updated
03/03/2026
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