Individual
DONNA JEAN LONGSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
22705 MERIDIAN AVE E, STE A, GRAHAM, WA 98338-7098
(253) 875-6400
Mailing address
4606 350TH ST E, EATONVILLE, WA 98328-9752
(253) 875-6400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00020280
WA
Other
Enumeration date
02/16/2007
Last updated
09/30/2014
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