Individual
CANDACE LARAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
925 8TH AVE N, SEATTLE, WA 98109-6304
(206) 631-2819
Mailing address
925 8TH AVE N, SEATTLE, WA 98109-6304
(206) 631-2819
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60795955
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60795955
MASSAGE LICENSE
WA
Enumeration date
05/22/2019
Last updated
05/22/2019
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