Individual
ANDREA BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
402 W WASHINGTON AVE APT E, YAKIMA, WA 98903-1400
(509) 453-7368
Mailing address
418 S 50TH AVE, YAKIMA, WA 98908-3417
(509) 901-8227
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60400375
WA
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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