Individual
ELISA MARIA KAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
11000 NW 21ST AVE, VANCOUVER, WA 98685-4965
(360) 600-4755
Mailing address
11000 NW 21ST AVE, VANCOUVER, WA 98685-4965
(360) 600-4755
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019750
WA
Other
Enumeration date
11/25/2008
Last updated
12/03/2008
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