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Individual

ANTONIO CARRANZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
410 BELLEVUE WAY SE STE 202, BELLEVUE, WA 98004-6649
(425) 378-1800
Mailing address
410 BELLEVUE WAY SE STE 202, BELLEVUE, WA 98004-6649

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60443157
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA60443157
MASSAGE THERAPIST LICENSE
WA
Enumeration date
03/01/2019
Last updated
03/01/2019
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