Individual
MISS BETHANY ASHTON MCCLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
5210 CORPORATE CENTER LOOP SE, SUITE D, LACEY, WA 98503-5952
(360) 455-8155
Mailing address
5210 CORPORATE CENTER CT NE, SUITE D, LACEY, WA 98503
(360) 455-8155
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00023986
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250028
DEPT OF L&I
WA
01
—
1043MC
REGENCE
WA
01
—
1044MC
REGENCE
WA
01
—
1046MC
REGENCE
WA
01
—
1047MC
REGENCE
WA
01
—
1048MC
REGENCE
WA
Enumeration date
12/16/2008
Last updated
08/20/2009
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