Individual
BONNIE JEAN GEDDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 MAIN AVE S, #201, RENTON, WA 98055-2758
(206) 240-2039
Mailing address
12708 13TH LN SW, #D5, BURIEN, WA 98146-4000
(206) 240-2039
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00013959
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159356
LABOR AND INDUSTRIES
WA
01
—
0213404
LABOR AND INDUSTRIES
WA
Enumeration date
04/24/2007
Last updated
07/08/2007
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