Individual
DONNETTA EYVONNE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
15805 15TH AVENUE CT E, TACOMA, WA 98445-5938
(253) 335-9532
Mailing address
15805 15TH AVENUE CT E, TACOMA, WA 98445-5938
(253) 335-9532
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0010211
WA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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