Individual
GENA GRANSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
102 5TH AVE APT 2-204, MILTON, WA 98354-8603
(253) 517-7123
Mailing address
PO BOX 5202, KENT, WA 98064-5202
(253) 520-0158
(253) 854-9860
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021491
WA
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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