Individual
GENEVA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
614 HARRISON ST, SUMNER, WA 98390-1100
(253) 293-0353
Mailing address
614 HARRISON ST, SUMNER, WA 98390-1100
(253) 293-0353
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60311816
WA
Other
Enumeration date
09/05/2012
Last updated
02/11/2024
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