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Individual

MR. DOUGLAS ALAN LEESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
616 IRONWOOD ST, OMAK, WA 98841-9545
(509) 429-8051
Mailing address
PO BOX 4303, OMAK, WA 98841-4303
(509) 429-8051

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00016504
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
165116
LABOR AND INDUSTRIES
WA
Enumeration date
06/08/2007
Last updated
02/14/2019
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