Individual
ANDREY KHABIBRAKHMANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
939 W T ST, WASHOUGAL, WA 98671-5161
(360) 773-0534
Mailing address
939 W T ST, WASHOUGAL, WA 98671-5161
(360) 773-0534
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61270218
WA
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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