Individual
MR. CHARLES MARTIN ERRUSARD DEVILLE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
4729 149TH AVE SE, BELLEVUE, WA 98006-3127
(425) 647-4231
Mailing address
4729 149TH AVE SE, BELLEVUE, WA 98006-3127
(425) 647-4231
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60163281
WA
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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