Individual
DANYEL LEANN PIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
311 N AMBOY AVE, YACOLT, WA 98675-5442
(360) 668-6085
Mailing address
PO BOX 516, YACOLT, WA 98675-0699
(360) 686-0851
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00023512
WA
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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