Individual
MS. EDEN STABENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
12001 PACIFIC AVE S, TACOMA, WA 98444-5101
(253) 535-6677
Mailing address
1602 EDGEWOOD DR NW, GIG HARBOR, WA 98332-9309
(253) 853-4858
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019473
WA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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