Individual
ANNALIE VIRGINIA DERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1916 23RD AVE S STE A, SEATTLE, WA 98144-4616
(206) 390-6088
Mailing address
3938 1/2 INTERLAKE AVE N, SEATTLE, WA 98103-8132
(630) 486-5849
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61635291
WA
225700000X
Massage Therapist
MT137444
TX
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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