Individual
AMANDA GOODWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
405 OZZIE ST NW, ORTING, WA 98360-7405
(253) 219-4000
Mailing address
405 OZZIE ST NW, ORTING, WA 98360-7405
(253) 219-4000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021848
WA
Other
Enumeration date
09/26/2007
Last updated
01/26/2010
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