Individual
AILEE S REGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6609 LONG LAKE RD SE, PORT ORCHARD, WA 98367-8623
(360) 649-3649
Mailing address
6609 LONG LAKE RD SE, PORT ORCHARD, WA 98367-8623
(360) 649-3649
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 60363506
WA
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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