Individual
BRIELLE KATHLEEN CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
15220 SE 272ND ST, SUITE G, KENT, WA 98042-4241
(253) 630-6768
Mailing address
7149 W EMERALD ST, BOISE, ID 83704-8620
(208) 941-4656
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-1602
ID
Other
Enumeration date
06/11/2009
Last updated
02/23/2024
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