Individual
ANGELA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
111 MARKET ST NE, SUITE 108, OLYMPIA, WA 98501-1008
(360) 754-7085
(360) 754-3671
Mailing address
5210 CORPORATE CENTER LOOP SE, SUITE D, LACEY, WA 98503-5952
(360) 455-8155
(360) 455-1655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0149551
DEPT. OF LABOR & INDUSTRY
WA
01
—
3456GR
REGENCE BLUESHIELD
WA
01
—
7174664
AETNA
WA
01
—
8903856
L & I CRIME VICTIMS
WA
Enumeration date
04/19/2006
Last updated
01/16/2009
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