Individual
MRS. CECILY KANINAWE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1815 HUDSON, STE B, LONGVIEW, WA 98632
(360) 423-3399
(360) 423-6181
Mailing address
1815 HUDSON, STE B, LONGVIEW, WA 98632
(360) 423-3399
(360) 423-6181
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00017316
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165991
WA STATE DEPT OF LABOR & INDUSTRIES
WA
Enumeration date
04/17/2009
Last updated
04/17/2009
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