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Individual

MS. ANITA L. FUNSETH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.P.

Contact information

Practice address
1318 WASHINGTON WAY STE B, LONGVIEW, WA 98632-3974
(360) 425-8909
(360) 425-6905
Mailing address
2527 30TH AVE, LONGVIEW, WA 98632-4364
(360) 414-1386

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00009138
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
188330
DEPT OF LABOR & INDS.
WA
Enumeration date
04/19/2007
Last updated
07/08/2007
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