Individual
MR. CHARLES Q.S. PETTEYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
8215 22ND AVE NE, SEATTLE, WA 98115-4513
(206) 523-4043
Mailing address
8215 22ND AVE NE, SEATTLE, WA 98115-4513
(206) 523-4043
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00022345
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0247833
WASHINGTON STATE DEPARTMENT OF LABOR & INDUSTRIES
WA
Enumeration date
06/19/2009
Last updated
06/19/2009
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