Individual
MS. GINA DIEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1560 3RD AVE, LONGVIEW, WA 98632-3229
(360) 423-9535
(360) 414-9284
Mailing address
1560 3RD AVE, LONGVIEW, WA 98632-3229
(360) 423-9535
(360) 414-9284
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00018700
WA
Other
Enumeration date
05/12/2010
Last updated
05/12/2010
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