Individual
EMILY ELIZABETH FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
703 BROADWAY ST STE 500, VANCOUVER, WA 98660-3307
(360) 609-0081
Mailing address
11420 NW 34TH CT, VANCOUVER, WA 98685-3441
(360) 609-0253
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61471601
WA
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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