Individual
MARY CATHERINE WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
430 W 2ND AVE, SUITE 101, SPOKANE, WA 99201-6003
(509) 863-5857
Mailing address
14907 W AUTUMN LN, NINE MILE FALLS, WA 99026-9643
(509) 465-4534
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60106211
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60106211
MASSAGE THERAPIST
WA
Enumeration date
02/19/2010
Last updated
02/19/2010
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