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Individual

MR. CARL I VANLOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.M.P.

Contact information

Practice address
402 22ND AVE S, SEATTLE, WA 98144-2269
(425) 745-4910
(425) 338-5709
Mailing address
16030 BOTHELL EVERETT HWY, STE 200, MILL CREEK, WA 98012-1741
(425) 745-4910
(425) 338-5709

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00012365
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0194907
DEPT. OF L&I
WA
01
2158VA
REGENCE
WA
Enumeration date
03/09/2007
Last updated
07/08/2007
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