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Individual

ANTOINETTE FAUSTINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1610 C ST STE 103, VANCOUVER, WA 98663-3400
(360) 694-0300
Mailing address
16530 NW JOSCELYN ST, BEAVERTON, OR 97006-5258
(503) 807-8713

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60077356
WA

Other

Enumeration date
03/26/2012
Last updated
03/26/2012
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