Individual
AMANDA MARIE JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
319 S 11TH AVE, YAKIMA, WA 98902-3213
(509) 453-1420
(509) 453-1453
Mailing address
319 S 11TH AVE, YAKIMA, WA 98902-3213
(509) 453-1420
(509) 453-1453
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60660506
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 60660506
MASSAGE PRACTITIONER LICENSE
WA
Enumeration date
08/06/2016
Last updated
08/06/2016
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