Individual
MS. BEVERLY NICOLE PRATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA60862028
Contact information
Practice address
1231 MILL CREEK BLVD APT I202, MILL CREEK, WA 98012-3086
(360) 201-6795
Mailing address
1231 MILL CREEK BLVD APT I202, MILL CREEK, WA 98012-3086
(360) 201-6795
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60862028
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60862028
WASHINGTON DOH
WA
Enumeration date
06/04/2018
Last updated
06/04/2018
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