Individual
ADAM K MATHIASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.P.
Contact information
Practice address
904 E CHESTNUT ST, BELLINGHAM, WA 98225-5223
(360) 650-1777
Mailing address
2815 HUMBOLDT ST, BELLINGHAM, WA 98225-2611
(360) 224-4249
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00016457
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0216329
LABOR & INDUSTRY
WA
Enumeration date
03/13/2007
Last updated
07/08/2007
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