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Individual

MS. DIANE LYNN AGNEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMP

Contact information

Practice address
6603 220TH ST SW STE 1, MOUNTLAKE TERRACE, WA 98043-2186
(425) 776-1056
Mailing address
6603 220TH ST SW STE 1, MOUNTLAKE TERRACE, WA 98043-2186
(425) 776-1056

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019886
WA

Other

Enumeration date
11/08/2006
Last updated
07/08/2007
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