Individual
GWENDOLYN LEE SHEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
12929 E SPRAGUE AVE, STE 104, SPOKANE VALLEY, WA 99216-0721
(509) 891-2368
Mailing address
1212 S. LLOYD ST., SPOKANE, WA 99212
(509) 413-2097
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 00020324
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 00020324
WASHINGTON DEPT. OF HEALTH MASSAGE PRACTITIONER LICENSE
WA
Enumeration date
08/14/2012
Last updated
08/14/2012
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