Individual
MRS. SONYA MARIE ELHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1329 BROADWAY, LONGVIEW, WA 98632
(360) 636-3442
Mailing address
1329 BROADWAY, SUITE 203, LONGVIEW, WA 98632
(360) 636-3442
(360) 636-3442
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
MA00003455
WA
225700000X
Massage Therapist
MA00003455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L&I
0225231
—
Enumeration date
09/29/2009
Last updated
09/29/2009
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