Organization
KAYLEE MATHEWS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLEE MATHEWS (LMP)
(253) 474-1234
Entity
Organization
Contact information
Practice address
5213 PACIFIC AVE, TACOMA, WA 98408-7695
(253) 474-1234
(253) 474-1942
Mailing address
5213 PACIFIC AVE, TACOMA, WA 98408-7695
(253) 474-1234
(253) 474-1942
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MA60519807
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60519807
MASSAGE THERAPIST
WA
Enumeration date
11/18/2014
Last updated
11/18/2014
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