Individual
CONSTANCE LYNN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
600 N 36TH ST STE 319, SEATTLE, WA 98103-8698
(206) 518-1623
Mailing address
4121 DAYTON AVE N, #101, SEATTLE, WA 98103-7745
(206) 518-1623
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
MA00017684
WA
225700000X
Massage Therapist
Primary
MA00017684
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA0017684
LICENSE, MASSAGE PRACTIT.
WA
Enumeration date
05/11/2007
Last updated
08/05/2009
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