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Individual

MR. BRENT M SANDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
2607 BRIDGEPORT WAY WEST, SUITE 1A, UNIVERSITY PLACE, WA 98466-4725
(253) 564-2353
(253) 565-1286
Mailing address
2607 BRIDGEPORT WAY WEST, SUITE 1A, UNIVERSITY PLACE, WA 98466-4725
(253) 564-2353
(253) 565-1286

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00008118
WA
225700000X
Massage Therapist

Other

Enumeration date
07/06/2006
Last updated
09/14/2010
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