Individual
MISS ANNA MAE BUELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
11921 CANYON RD E, SUITE A, PUYALLUP, WA 98373-4403
(253) 254-1619
Mailing address
11921 CANYON RD E STE A, PUYALLUP, WA 98373-4403
(253) 254-1619
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60142126
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60142126
MASSAGE LICENSE #MA60142126
WA
Enumeration date
05/31/2010
Last updated
06/02/2010
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