Individual
CONNIE DANIELLE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
365 RENTON CENTER WAY SW, SUITE F, RENTON, WA 98057-2324
(425) 226-7061
(425) 226-7063
Mailing address
201 SW 5TH PL, M 201, RENTON, WA 98057-5834
(832) 613-3845
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60092681
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 60092681
LMP
WA
Enumeration date
09/21/2009
Last updated
09/21/2009
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