Individual
KERRY THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
120 STATE AVE NE, #175, OLYMPIA, WA 98501-1131
(360) 951-6937
Mailing address
120 STATE AVE NE, #175, OLYMPIA, WA 98501-1131
(360) 951-6937
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60404003
WA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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