Individual
ELISE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3200 CAPITAL MALL DR SW, BB301, OLYMPIA, WA 98502-8658
(360) 704-0823
Mailing address
3200 CAPITAL MALL DR SW, BB301, OLYMPIA, WA 98502-8658
(360) 704-0823
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60437534
WA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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