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Individual

GLENDA MAE LEWIS VII

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
3309 108TH ST SE, EVERETT, WA 98208
(425) 338-0910
(425) 379-6222
Mailing address
3309 108TH ST SE, EVERETT, WA 98208
(425) 338-0910
(425) 379-6222

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
RC0047444
WA
225700000X
Massage Therapist
Primary
MA00002002
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8442
L AND I
WA
01
LE9077
REGENCE
WA
Enumeration date
08/15/2006
Last updated
11/12/2008
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