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Individual

GINA TYNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
604 W 4TH AVE, SUITE B, TOPPENISH, WA 98948-1673
(509) 865-5636
(509) 865-2053
Mailing address
2021 VINTAGE RD, ZILLAH, WA 98953-9612
(509) 865-5636

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00009168
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0193553
LABOR & INDUSTRIES
WA
01
5636TY
REGENCE
WA
Enumeration date
04/19/2007
Last updated
07/08/2007
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