Individual
MISS ALIE KRISTIN RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
909 MAIN ST, VANCOUVER, WA 98660-3135
(360) 326-5852
(360) 695-0268
Mailing address
909 MAIN ST, VANCOUVER, WA 98660-3135
(360) 326-5852
(360) 695-0268
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00022143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00022143
MASSAGE PRACTITIONER
WA
Enumeration date
08/16/2007
Last updated
09/05/2008
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