Individual
MRS. CRYSTAL M BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
12214 SE MILL PLAIN BLVD STE 101, VANCOUVER, WA 98684-6019
(360) 944-1800
Mailing address
12214 SE MILL PLAIN BLVD STE 101, VANCOUVER, WA 98684-6019
(360) 944-1800
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60557076
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60557076
LMT LICENSE NUMBER
WA
01
—
MA60557076
MASSAGE LICHENS NUMBER
—
Enumeration date
07/30/2018
Last updated
07/30/2018
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