Individual
CHARITY L. WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
611 S 48TH AVE, B, YAKIMA, WA 98908-3614
(509) 952-3455
(509) 469-1905
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(509) 469-1903
(509) 469-1905
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00021144
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206031
WA LABOR & INDUSTRIES
WA
Enumeration date
11/28/2006
Last updated
05/05/2010
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