Individual
MR. CHARLES Q.S. PETTEYS
Active
Individual
MR. CHARLES Q.S. PETTEYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
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
Update your record
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