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Individual

MRS. CASILDRA J KUMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
740 VETERANS AVE, WESTPORT, WA 98595
(360) 268-0201
Mailing address
PO BOX 773, WESTPORT, WA 98595
(360) 268-0201

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0014367
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0196004
L & I
Enumeration date
04/06/2007
Last updated
07/08/2007
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