Individual
GREY LUNA JACK RIVERSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16398 NE 85TH ST STE 100, REDMOND, WA 98052-3555
(425) 636-1569
Mailing address
21040 NE WOODINVILLE DUVALL RD, WOODINVILLE, WA 98077-7748
(425) 505-7747
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00023063
WA
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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