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Individual

MICHAEL ROSENGRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
10655 NE 4TH STREET SUITE 101, BELLEVUE, WA 98004
(425) 455-2225
(425) 454-7767
Mailing address
10655 NE 4TH ST STE 101, BELLEVUE, WA 98004-5022
(425) 455-2225
(425) 454-7767

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60558795
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA60558795
MASSAGE LICENSE
WA
Enumeration date
10/07/2015
Last updated
10/07/2015
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