Individual
ELIZA WERTH-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20653
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0330373
WA L&I
OR
Enumeration date
06/03/2014
Last updated
10/13/2014
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