Individual
MRS. DIANE COLLEEN AFFHOLTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1120 S 4TH ST, SUNNYSIDE, WA 98944
(509) 837-2600
(509) 837-2291
Mailing address
1260 BLAINE RD, ZILLAH, WA 98953
(509) 781-0549
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021310
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201176
LTD
WA
Enumeration date
03/03/2006
Last updated
07/08/2007
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