Individual
CYNTHIA DAWN FAJMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
4915 FLORES LANE, PASCO, WA 99301
(509) 860-3576
Mailing address
4915 FLORES LN, PASCO, WA 99301-7909
(509) 860-3576
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00022178
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00022178
MASSAGE LICENSE
WA
Enumeration date
05/11/2007
Last updated
09/11/2007
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