Individual
ANDREA LYNN NEATHERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
400 WEST WISHKAH ST, ABERDEEN, WA 98520
(360) 533-6920
(360) 533-8005
Mailing address
PO BOX 849, COSMOPOLIS, WA 98537
(360) 580-9928
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103252
L & I
—
01
—
225969100000
PREMERA
—
Enumeration date
04/06/2007
Last updated
07/25/2007
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