Individual
MISS ELLEN ELIZABETH KLISSUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA60346418
WA
225800000X
Recreation Therapist
Primary
80817
WA
Other
Enumeration date
05/20/2013
Last updated
07/22/2021
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