Individual
BRADEN WAYNE PEWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
718 S COLLEGE AVE, COLLEGE PLACE, WA 99324-1519
(509) 240-4913
Mailing address
718 S COLLEGE AVE, COLLEGE PLACE, WA 99324-1519
(509) 240-4913
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60305071
WA
Other
Enumeration date
01/10/2013
Last updated
12/20/2013
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