Individual
GAREK STAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1319 NE 134TH ST, VANCOUVER, WA 98685-2717
(360) 574-3141
(360) 326-1662
Mailing address
16700 NE 6TH ST, VANCOUVER, WA 98684-3708
(971) 570-6984
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60858653
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60858653
OTHER
WA
Enumeration date
05/23/2018
Last updated
05/23/2018
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