Individual
ALISA POPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
14709 AURORA AVE N, SHORELINE, WA 98133-6547
(206) 363-4478
Mailing address
14709 AURORA AVE N, SHORELINE, WA 98133-6547
(206) 363-4478
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60519253
WA
Other
Enumeration date
05/01/2015
Last updated
05/01/2015
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