Individual
ELENA POLOZKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 FARALLONE AVE, FIRCREST, WA 98466-6700
(304) 932-4872
Mailing address
1302 FARALLONE AVE, FIRCREST, WA 98466-6700
(304) 932-4872
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60583021
WA
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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