Individual
MR. GRADY TIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.P
Contact information
Practice address
1815 HUDSON ST, LONGVIEW, WA 98632-2913
(360) 636-2636
Mailing address
1815 HUDSON ST, LONGVIEW, WA 98632-2913
(360) 636-2636
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60343680
WA
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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