Individual
MS. ELAINE MARIE MATTESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
311 COOKSON ST, SHELTON, WA 98584-2219
(360) 259-6313
Mailing address
311 COOKSON ST, SHELTON, WA 98584-2219
(360) 259-6313
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60241008
WA
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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