Individual
DWAINE JEFFREY BREED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
101 E MAIN ST, #201, MONROE, WA 98272-1519
(360) 863-0642
Mailing address
15515 JUANITA WOODINVILLE WAY NE, E-304, BOTHELL, WA 98011-1576
(425) 328-9413
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60116962
WA
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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