Individual
MS. ANITA AYN REDISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
7612 NE HAZEL DELL AVE, VANCOUVER, WA 98665-8224
(360) 694-1575
Mailing address
7514 VIRGINIA LN, VANCOUVER, WA 98664-2169
(360) 901-5882
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
00016105
WA
Other
Enumeration date
06/19/2010
Last updated
06/19/2010
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